OneCare (HMO SNP)

Medication Therapy Management

Or Medicine Review Program

We can help you stay healthy with the Medication Therapy Management (MTM) Program. It is also known as the Medicine Review Program. The program gives you the tools you need to get the most from your medicines. We offer the MTM Program to members of OneCare (HMO SNP) at no cost.

We choose members who are at the highest risk for medicine problems to be in MTM. The program offers you a pharmacist to talk to at no cost. Our MTM trained pharmacists teach you how to take your medicine in a safe and proper way. Taking your medicine, the correct way helps prevent side effects from your medicine. It can also lower your out-of-pocket costs.

Comprehensive medication review

As part of the MTM Program, a pharmacist does a comprehensive medication review (CMR) with you. We can do the CMR with you in person or over the phone. Your CMR may take 30 to 60 minutes.

During your CMR, the pharmacist looks at:

  • Why you are taking each of your medicines
  • If the medicines you are using are working for you
  • If your medicines are causing any side effects or making you sicker
  • If your medicines affect each other, foods or over-the-counter medicines
  • If there are ways to lower the number of medicines, you are taking

After meeting with a pharmacist, we will mail you 2 documents:

  • Medication action plan: Shows you steps you can take to get the most out of your medicines.
  • Personal medication list: For you to list all your medicines, how you take them and why you take them.
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Personal Medication List Download PDF Icon Download the blank form to track other medicines or update your list.

Targeted medication reviews

Pharmacists performs targeted medication reviews (TMR) at least once each quarter. The pharmacist looks at only some of the medicines you take to see if there are problems that could put you at risk. If you are at risk, the pharmacist will tell your doctor.

MTM eligibility requirement

Once a quarter, we select members to take part in the MTM program. If chosen, we will mail you a letter to let you know.

You are chosen for MTM if A, B and C apply to you:
A. You receive medicines for 3 or more of the following conditions:

  • Diabetes
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Hypertension or high blood pressure
  • Dyslipidemia or high cholesterol
  • End-Stage Renal Disease (ESRD)

B. You are taking 8 or more medicines through OneCare per quarter
C. You will likely exceed $4,044 in medicine costs per year

If you do not wish to be part of this program, to opt out please call OneCare Customer Service at 1-877-412-2734, 24 hours a day, 7 days a week. We have staff who speak your language. TDD/TTY users can call toll-free at 1-800-735-2929.

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To file a complaint with Medicare, click on the following link to complete a complaint form on the Medicare website: Medicare Complaint Form.

H5433_WEB020_M Accepted 06/17/19

OneCare (HMO SNP) is a Medicare Advantage organization with a Medicare contract. Enrollment in OneCare depends on contract renewal. Eligible beneficiaries can enroll at any time. Eligible beneficiaries must have Part A and Part B to enroll in the plan. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. Co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Other Pharmacies/Physicians/Providers are available in our network. Medicare beneficiaries may also enroll in OneCare (HMO SNP) through the CMS Medicare Online Enrollment Center located at Medicare has neither reviewed nor endorsed this information. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. OneCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. This information is available for free in other languages. Please call our customer service number at 1-877-412-2734, 24 hours a day, 7 days a week. TDD/TTY users should call 1-800-735-2929.

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