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Medication Therapy Management

Braven Health’s Medication Therapy Management (MTM) Program is part of our Medicare Advantage plans with prescription drug coverage. The Centers for Medicare and Medicaid Services (also called CMS) requires all Medicare Part D sponsors to offer an MTM program to eligible members. To be eligible for the Medication Therapy Management program, you must:

  1. Have at least three chronic conditions from this list:
    • Alzheimer’s
    • Diabetes
    • Dyslipidemia
    • Hypertension
    • Depression
    • Multiple Sclerosis
  2. Take eight or more Part D covered drugs to treat your chronic conditions.
  3. Have an expected cost of at least $4,376 a year or $1,094 per quarter for your Part D covered drugs in 2021.

How does the MTM program benefit me?
The MTM program was designed with your health as our top priority and is a service to use in addition to the conversations with your doctor and pharmacists. The aim of the MTM program is to work with you and your doctor to help you achieve and maintain the safest and most effective medication therapy for you. The program helps you, your doctor, and your health care team strengthen the management of medications by:

  1. Empowering you to take an active role in your health care experiences
  2. Providing you with education material to help you achieve and maintain your best level of health:
    • Fact sheets on your chronic conditions.
    • Tips and tricks.
    • Information about nutrition and physical activity.
    • Recommended goals.
  3. Providing you with the opportunity to speak with a live pharmacist.
  4. Performing targeted reviews every quarter to ensure there are no safety concerns, missed opportunities or issues such as:
    • Taking similar medications.
    • Gaps in therapy.
    • Taking medicines with in U.S. Food and Drug Administration (FDA) guidelines.
    • Interactions between your medications.

    If there are any safety concerns, missed opportunities or issues, we will notify you, your doctor and/or your health care team by mail or telephone.

  5. Providing you, your doctor and your health care team with current information on your medications and chronic conditions.

Our team of trusted pharmacists may reach out to you or your doctor to alert you to any gaps in therapy or safety concerns. He or she will work with you to schedule an appointment to speak with one of our trusted pharmacists on the telephone to participate in a Comprehensive Medication Review.

What is a Comprehensive Medication Review?
CMS requires all MTM programs to complete a Comprehensive Medication Review (CMR) with each member. A CMR is a review of all your prescription medications, over-the-counter medications (medications such as aspirin or heartburn pills), vitamins and herbal supplements with a trusted pharmacist over the telephone.

  1. A CMR can help you better understand your medications by explaining how they work best and what to watch out for.
  2. During a CMR you will receive personal attention from one of our trusted pharmacists without being rushed.
  3. Along with reviewing your medications, the pharmacist will answer your medication questions.
  4. The pharmacist can also help you with general answers to questions you have about your health.
  5. A written summary of the discussion, including a personal medication list with counseling points, will be sent to you for your personal records within 14 days of the review.
  6. A copy of the written summary will also be sent to up to three of your doctors so that you and your doctors can address your health issues together.

How much will the MTM program cost me?
The MTM program and its services are provided to you for no cost.

How will the MTM program affect my plan coverage?
The MTM program is not considered part of your plan benefits and will not affect your coverage in any way. The MTM program is a free health service program offered to eligible members.

How do I enroll in the MTM program?
You do not need to do anything to enroll in the MTM program. We will automatically enroll you and send you a welcome letter if you are eligible for the program. Along with the welcome letter, you will receive a short form to fill out and return to us in the postage paid envelope to help us schedule your CMR. You may also be called to schedule a CMR or you can call us directly to schedule a CMR or to speak with a pharmacist.

To speak with one of our MTM team members, call 1-888-706-2820 (TTY 711), Monday through Friday, between 9 a.m. and 5 p.m., ET. Due to high call volume, you may get the MTM voicemail. Please leave your name and a call back number we will return your call promptly.

You can write to us:
Braven Health
Attn: Medication Therapy Management Program
3 Penn Plaza East
Newark, NJ 07105