Members

Medication Therapy Management Program

senior woman

Can I get help managing my prescriptions (Medication Therapy Management MTM)?

Molina’s Medication Therapy Management (MTM) program is a service provided at no cost. MTM is not considered a benefit and is offered to members that meet certain criteria. A pharmacist or other trained provider will review your prescription, over-the-counter (OTC) and supplement/herbal medications with you. They will review with you over the phone or in person at your local pharmacy. The goal of MTM is to help you understand your medicines, resolve side effects and answer questions about your medication.

How do I qualify for MTM?

Molina determines MTM eligibility on a quarterly basis. We use medical and pharmacy claims information. You qualify for MTM if you meet each of the three criteria below:

1. Have three or more of the following conditions:

  • Alzheimer's Disease
  • Bone Disease-Arthritis (including osteoarthritis, osteoporosis, and rheumatoid arthritis)
  • Chronic Heart Failure (CHF)
  • Diabetes
  • Dyslipidemia
  • End-stage renal disease (ESRD)
  • Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)
  • Hypertension
  • Mental health (including depression, schizophrenia, bipolar disorder, and other chronic/disabling mental health conditions)
  • Respiratory Disease (including asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders)

2. Take at least eight maintenance Part D drugs

3. Are likely to incur annual costs for covered Part D drugs equal to or greater than $1,276 in 2026

You may also qualify if you take certain pain management medications.

You will be automatically enrolled in the MTM program if you qualify. You will get a letter with info about the program and how to contact us. We may also call you to schedule a visit to speak with a pharmacist.

 

What is discussed during my MTM consultation?

In the comfort of your own home, a pharmacist or other trained health care provider will help you:

  • Review all your prescription, over-the-counter (OTC) and supplement/herbal medicines
  • Discuss side effects you may have when taking certain medicines
  • Answer questions you have about your medicine
  • Suggest potential improvements to your medication regimen
  • Make a list of your medicines with when and how you should take them
  • Create goals for taking your medicine
  • CMR Summary Letter will be mailed to you after conversation

 

MTM is performed over the phone. The appointment will last about 30 minutes. After the appointment, you will be mailed a Personal Medication List that you can share with your health care providers. You will also be mailed a Medication Action Plan that summarizes what was discussed during your MTM encounter. If the MTM provider has any concerns about your medications, such as drug interactions, your prescribing doctors will be made aware. You should do this Comprehensive Medication Review at least once a year. If possible, complete it before your annual wellness visit with your doctor.

How do I contact Molina to ask about MTM?

Call (855) 658-0918, TTY/TDD 711, Monday – Friday, 9 a.m. – 8 p.m., local time.