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Medication Therapy Management

If you have more than one long-term health condition, take many medications every day, and have an expensive drug therapy regimen, you might feel like you could use some extra help managing your medications.

UPMC Health Plan’s Medication Therapy Management (MTM) program is available at no cost to you. The program is administered by a team of health care professionals that includes pharmacists, registered nurses, and social workers. The MTM program helps Medicare members better manage their medications and helps promote safe and effective medication use.

If you meet the criteria below, you are automatically enrolled in the program. If you do not want to participate in this program, please call 1-844-870-2224 (TTY: 711) Monday through Friday from 9 a.m. to 5 p.m. But the program is very helpful. It includes:

  • Monthly targeted medication reviews to look for drug-therapy problems, such as drug interactions, high doses, duplications in drug therapy, and gaps in care (care you should have gotten but did not). We will notify your prescriber via letter or phone call if any issues are identified. You may also receive a letter or a brief phone call from a health care professional following up about important medication(s) to ensure you are not experiencing any problems or concerns.
  • An annual Comprehensive Medication Review (CMR). This is a brief phone call between you and a pharmacist where the pharmacy will review all your medications (including prescription, over-the-counter medications, and herbal supplements) and listen to any concerns you have about them. After the CMR, you will receive a recommended to-do list and personal medication list in the mail. These materials are sent out within 14 days of the CMR. View a blank copy of the personal medication list.

Who is eligible for UPMC for Life's medication therapy management program?

2024
You will be automatically enrolled in UPMC for Life's's MTM program if you meet the following criteria:

  • You have three or more of the following chronic diseases (based on claims data):
    • Asthma
    • Chronic heart failure (CHF)
    • Diabetes
    • High cholesterol
    • HIV/AIDS
    • High blood pressure
    • Osteoporosis
    • Rheumatoid arthritis
  • AND have eight or more chronic/maintenance Part D covered drugs within a 90-day period,
  • AND are likely to incur annual costs that meet or exceed $5,330 for all covered Part D drugs. (UPMC for Life estimates that members whose drug costs equal or exceed $1,332.50 in a 90-day period will have an annual drug cost of at least $5,330.)

You may also be enrolled in the Medication Therapy Management program if you have been identified as an At-Risk Beneficiary (ARB) in our Drug Management Program.

What happens after I am enrolled in UPMC for Life's's Medication Therapy Management program?

When you become eligible for the Medication Therapy Management program, you will receive a welcome letter that:

  • Notifies you of your enrollment in the program.
  • Provides instructions on how to schedule a CMR.
  • Provides instructions on how to opt out of the MTM program.

Members who do not respond to the letter may receive automated phone calls, calls from a pharmacy representative, text messages, and/or e-mails to schedule a CMR. Members in the MTM program may also receive phone calls from a registered nurse, social worker, and/or case manager.

How can I safely dispose of my medications?

We value your safety and that of those around you. Unused or expired prescription medications are a public safety issue. Proper disposal of unused drugs saves lives and protects the environment. Unused medications should be disposed of as soon as possible using one of the following methods:

  • Community take-back sites are the preferred method of disposing of unused controlled substances. Locate a take-back site in your community.
  • The U.S. Drug Enforcement Administration (DEA) allows unused prescription medications to be mailed back to pharmacies and other authorized sites using packages made available at such locations. Check with your local pharmacy to see if they are a participating site.
  • At-home disposal is an option if you cannot get to a drug take-back location promptly or there is none near you.
  • If your medicine is on the FDA flush list, you can immediately flush these potentially dangerous medicines down the toilet. Find out if your medication is on the FDA flush list by visiting the Disposal of Unused Medicines resource or check the label or the patient information leaflet with your medicine.
  • If your medicine is not on the flush list, you should follow these instructions to discard the medicine in your trash at home:
    • Conceal or remove any personal information, including Rx number, on any empty medication containers.
    • Mix the drugs with an undesirable substance such as dirt or used coffee grounds, place the mixture in a sealed container, such as an empty margarine tub, and discard in the trash.
  • Drug deactivation kits for in-home disposal of unused medications may be available in your community. Ask your local pharmacist for more information.

Additional information can be found at the following websites:

Any questions about how to dispose of unused or expired medications?

Talk to your local pharmacist or give us a call toll-free at the phone number below.

Contact us today

If you’re ready to schedule your comprehensive medication review or have any questions, give us a call! You can reach us toll-free at 1-844-870-2224 (TTY: 711) Monday through Friday from 9 a.m. to 5 p.m. You can also schedule a video chat with one of our licensed pharmacists through the UPMC Anywhere Care app. If using your desktop, go to UPMC AnywhereCare.

The MTM program and services are not considered a plan benefit.

This information is not a complete description of benefits. Call 1-866-400-5077 (TTY: 711) for more information. Out-of-network/Noncontracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services. Other physicians/providers are available in the UPMC for Life network.

This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711).

UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life is a product of and operated by UPMC Health Plan Inc., UPMC Health Network Inc., UPMC Health Benefits Inc., and UPMC Health Coverage Inc.

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UPMC for Life Members
Call us toll-free: 1-877-539-3080
TTY: 711

Oct. 1 – March 31:
Seven days a week from 8 a.m. to 8 p.m.

April 1 – Sept. 30:
Monday through Friday from 8 a.m. to 8 p.m., Saturday from 8 a.m. to 3 p.m.

UPMC for Life Prospective Members
Call us toll-free: 1-866-400-5077
TTY: 711

Jan. 1 – Sept. 30:
Seven days a week from 8 a.m. to 8 p.m.

Oct. 1 – Dec. 31:
Seven days a week from 7 a.m. to 9 p.m.

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Last Updated: 1/19/2024