Medication therapy management
What is 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 pharmacist 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?
2025
You will be automatically enrolled in UPMC for Life's MTM program if you meet the following criteria:
- You have three or more of the following chronic diseases (based on claims data):
- Alzheimer’s disease
- Bone disease-arthritis (osteoporosis, osteoarthritis, and rheumatoid arthritis)
- Chronic congestive heart failure (CHF)
- Diabetes
- High cholesterol
- End-stage renal disease (ESRD)
- HIV/AIDS
- High blood pressure
- Mental health (depression, schizophrenia, bipolar disorder, and chronic/disabling mental health conditions)
- Respiratory disease (asthma, chronic obstructive pulmonary disease, and chronic lung disorders)
- AND have eight or more Part D covered drugs within a 90-day period,
- AND are likely to incur annual costs that meet or exceed $1,623 for all covered Part D drugs. (UPMC for Life estimates that members whose drug costs equal or exceed $405.75 in a 90-day period will have an annual drug cost of at least $1,623.)
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 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 emails to schedule a CMR. Members in the MTM program may also receive phone calls from a registered nurse, social worker, and/or case manager.
Additional resources
- 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 AnywhereCare app. If using your desktop, go to UPMC AnywhereCare.
- 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. Learn how to safely dispose of your medications.
The MTM program and services are not considered a plan benefit.
Contact us
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.
UPMC for Life Prospective Members
Call us toll-free: 1-866-400-5077 (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 9 a.m. to 3 p.m.
Medicare resources
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 D-SNP, and PPO plans. The HMO D-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., UPMC for You 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.
UPMC for Life Prospective Members
Call us toll-free: 1-866-400-5077
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 9 a.m. to 3 p.m.
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Last Updated: 1/2/2025