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Medication Therapy Management

The Healthy Living Program

 

Medication Therapy Management (MTM) programs are required by the Centers for Medicaid and Medicare Services (CMS) for all Part D Prescription Drug Plans (PDP) and Medicare Advantage Plans (MA). The program is not considered a benefit, but rather a free service offered to those who are eligible and qualify for the program. There is no change to your insurance benefits, co-pays, prescription coverage, or available doctors or pharmacies.  

 

Our MTM program is called the Healthy Living Program. The Healthy Living Program allows access to medical professionals to answer any questions that you may have about your medications or your health through our HealthLine Hotline. WellCare has developed specific criteria using the general guidelines provided by CMS to enhance the care of our Medicare MTM members.

 

Medicare Enrollees Who Are Eligible:

 

  • Have at least three chronic medical conditions.
  • Take at least seven covered Part D chronic maintenance medications per month.
  • Have a projected annual drug expense of over $3,017 per year. This includes the amount you pay and we pay for your prescriptions.  

 

How Eligible Enrollees Are Notified:


Medicare requires we automatically enroll you in to the MTM program when you qualify, but participation is voluntary.  The Healthy Living Program will contact you directly when you are enrolled into the program via telephone and/or mailings.  You may also be notified by your healthcare provider (doctor, pharmacist, or nurse) if they are aware of your enrollment in the program.

 

For More Information or to Opt out of the Program:

  • Call the MTM HealthLine Hotline at 1-866-339-2787 (TTY users dial 711), Monday – Friday, 9 a.m. to 7 p.m. Eastern.
  • Send an email to MTMQuestions@wellcare.com.
     

Y0070_NA023899_WCM_WEB_ENG CMS Approved


Last modified: 01/01/2014

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