Medication Therapy Management (MTM)

1. Comprehensive Medication Review (CMR): Once a year, a pharmacist will talk with you by phone (about 30–60 minutes) to go over all your medicines, including prescriptions, over-the-counter drugs, vitamins, and supplements.
2. Targeted Medication Reviews (TMR): At least every three months, we check for any medicine problems. This happens even if you choose not to have a CMR. We also check your medicines if you have a change in care, such as coming home from the hospital.
3. Written Summary: After your CMR, you will get a Personal Medication List (PML) and a Medication Action Plan (MAP).
4. Personal Medication List (PML): A simple list of all your medicines.
5. Medication Action Plan (MAP): A list of steps to help you get the best results from your medicines.
6. Doctor Communication: We may contact your doctors to share helpful suggestions about your medicines.
7. Caregiver Support: Services available through authorized representatives for members who need assistance.

1. Pharmacy Take-Back Programs: Many pharmacies accept unused medications year-round. Ask your pharmacist if they have a disposal program.
2. National Drug Enforcement Administration (DEA) Take Back Days: The DEA sponsors collection events twice a year (usually in April and October) at locations throughout our service area.
3. Authorized Collection Sites: Permanent drop-off locations are available at many police stations, hospitals, and pharmacies.
4. Mail-Back Programs: Some pharmacies provide special packages for mailing unused medications safely.

During your MTM consultation, our pharmacist will provide you with locations of two (2) drug disposal sites near your home.

You may qualify for our MTM program if you meet all three of these conditions:

You have multiple chronic health conditions

You have three (3) or more of these health conditions that require ongoing treatment:

• Alzheimer’s disease
• Bone disease or arthritis (including osteoporosis, osteoarthritis, and rheumatoid arthritis)
• Heart failure (congestive heart failure)
• Diabetes
• High Cholesterol (dyslipidemia)
• End-stage kidney disease
• HIV/AIDS
• High blood pressure (hypertension)
• Mental health conditions (such as depression, schizophrenia, or bipolar disorder)
• Respiratory disease (such as asthma or COPD)

You take several prescription medicines.

You regularly take eight (8) or more medicines that are covered by Medicare Part D. This includes all Part D maintenance drugs.

Your yearly drug costs meet the Medicare limit.

Your total yearly drug costs are likely to be $1,276 or more in 2026 (this amount is updated every year by Medicare). This total includes what you pay and what your plan pays.

If you qualify:
You do not need to apply. We review member information regularly. If you are eligible, we will send you a letter inviting you to join the program. You will be enrolled automatically unless you tell us you do not want to participate.

Special Note:
If you are identified as an At-Risk Beneficiary in our Drug Management Program for safe medication use (including certain pain medicines), you will automatically be enrolled in MTM services at no cost to you — even if you do not meet the other criteria above.

Getting started with MTM is easy and convenient:

1. Receive Your Invitation: If you qualify, we will send you a letter with program details and contact information.
2. Schedule Your Review: Call us to schedule your comprehensive medication review at a time that works for you.
3. Prepare for Your Call: Gather all your medications, including prescriptions, over-the-counter drugs, vitamins, and supplements.
4. Complete Your Review: Speak with our clinical pharmacist about all your medications during a comprehensive phone consultation (usually takes 30-60 minutes).
5. Receive Your Materials: Get your written summary including a personalized Medication Action Plan and updated Personal Medication List.
6. Follow Your Action Plan: Use the personalized plan we create together to manage your medications.
7. Stay Connected: Receive quarterly follow-up reviews and ongoing support as needed.

• Phone Consultation: All comprehensive medication reviews are conducted by phone for your convenience.
• Private & Confidential: All conversations are protected by healthcare privacy laws.
• No Pressure:Participation is completely voluntary – you can opt out anytime.
• Available in Spanish: All services are available in English and Spanish.
• Caregiver Assistance: Family members or caregivers can participate with your permission.

Participation in MTM is completely voluntary. If you decide not to participate or want to stop receiving MTM services, simply call our Pharmacy Customer Service line at 1-833-726-0676 or  TTY: 711 (for members who are deaf, hard of hearing, or have a speech disability). You can always change your mind and rejoin the program later if your situation changes.

Helpful Tools for You
Medication Tracker: Keep a current list of all your medications, including dosages and when you take them.
Emergency Contact Card: Carry our MTM phone number with you in case you have medication questions while out.
Medication Organizer: Ask our pharmacist about pill organizers and other tools to help you stay on track.
Educational Materials: We provide written information about your specific conditions and medications.

Your privacy is important to us. We follow federal privacy laws, including the HIPAA Privacy Rule, to protect your personal health information.

Information you share during your MTM services will only be used to help improve your medication therapy and coordinate your care with your healthcare providers.

To learn more about how we may use and share your health information, your privacy rights, and how you can get a copy of your records, please read our Notice of Privacy Practices. This notice explains:

• How we use and share your health information.
• Your rights, such as seeing your records or asking us to make changes.
• What to do if you think your privacy rights have been violated.
• How to contact our Privacy Officer with questions or complaints.

Civil Rights Compliance
CenCal Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Language Assistance
If you speak a language other than English, language assistance services are available to you free of charge. Call 1-833-726-0676.

TTY Services
If you are deaf, hard of hearing, or have a speech disability, call 711 for free relay services.

Program Cost
MTM services are provided as part of your CenCal CareConnect (HMO D-SNP) plan benefits at no cost to you. There are no copays, deductibles, or extra charges for participating.

Vendor Partnership
MTM services are offered through our partnership with MedImpact Healthcare Systems.

If you qualify, you will get a letter from us with program details. You will be automatically enrolled unless you tell us you do not want to join (opt-out). You can stop at any time and rejoin later.

MTM services are free for all qualifying CenCal CareConnect  members. There are no copays, deductibles, or additional costs.

A comprehensive medication review usually takes 30 to 60 minutes, depending on how many medications you take. We will work at your pace to make sure you understand everything.

Absolutely! MTM services work alongside your current healthcare team. You can keep seeing all your current doctors and using your preferred pharmacy. We will actually help coordinate your care better.

Please gather all your medications before your call, including:

• All prescription medications (have the actual bottles available)
• Over-the-counter medicines like pain relievers, antacids, cold medicines
• Vitamins, minerals, and dietary supplements
• Herbal products and natural remedies
• A list of any drug allergies or bad reactions you’ve had

You will receive at least one (1) comprehensive medication review each year. You may also get additional targeted medication reviews at least quarterly if your medications change, if we identify specific issues to address, or if there are medication-related problems that need attention. We also review eligibility quarterly to ensure continuity of care.

We review eligibility at least quarterly throughout the year and perform an end-of-year analysis to promote continuity of care. If your health conditions or medications change, you might become eligible later. You can also call us anytime if you have questions about your medications.

With your permission, our pharmacist may send recommendations to your healthcare providers to help optimize your medication therapy. We can communicate with your doctors through fax, mail, or phone calls to ensure all your healthcare team is working together for your best health outcomes.

Please gather all your medications before your call, including:

• All prescription medications (have the actual bottles available)
• Over-the-counter medicines like pain relievers, antacids, cold medicines
• Vitamins, minerals, and dietary supplements
• Herbal products and natural remedies
• A list of any drug allergies or bad reactions you’ve had

All MTM services are available in English and Spanish. If you need services in another language, please let us know and we will arrange for interpretation services.

Yes! Part of your MTM service includes a Personal Medication List that you can print and take to doctor appointments, the pharmacy, or keep for emergencies. We will update this list as your medications change.

Absolutely! If you have cognitive challenges or need assistance, our MTM services can be provided to your authorized representative, such as a family member or caregiver. We also provide services to members in long-term care facilities. Just let us know how we can best support you.

After your comprehensive medication review, you will receive a written summary that includes your updated Personal Medication List and a Medication Action Plan with specific tasks and recommendations. If our pharmacist identifies any issues that need your doctor’s attention, we may contact your healthcare provider with recommendations.