Medication Therapy Management

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 offered free of charge, and is not considered a benefit. There is no change to insurance benefits, co-pays, prescription coverage, or available doctors or pharmacies. MTM programs are required by CMS to include enrolless that meet the following requirements:

• Medication expense of over $3,100.20 per year
• Multiple chronic diseases
• Multiple medications

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 are eligible for the Healthy Living Program if they meet all of the following criteria:

1. The Medicare enrollee must have three chronic medical conditions
2. The Medicare enrollee must receive a minimum of seven covered chronic maintenance medications per month
3. The Medicare enrollee must have a projected annual drug expense of over $3,100.20 per year (this includes member and insurance plan total cost)

Medicare requires that MTM programs automatically enroll those who qualify, but participation is voluntary, and members are given the opportunity to opt out at any time.

If you choose to opt out from the MTM program, please do one of the following:

• Call the MTM Department at 1-866-339-2787 (TTY users dial 711), Monday - Friday, 9 am to 7 pm Eastern
• Send an email to MTMQuestions@wellcare.com
• Check the appropriate box on the form included with your MTM program welcome letter, and return it in the self-addressed, pre-paid envelope that was included with the letter