Medication Therapy Management (MTM) Program

The CommunityCare Prescription Drug Plan medication therapy management program helps you get the greatest health benefit from your medications by:

Who qualifies for the program?

We will automatically enroll you in the CommunityCare Prescription Drug Plan program at no cost to you if all three conditions apply:

  1. You take eight or more Medicare Part D covered maintenance drugs, and
  2. You have three or more of these long-term health conditions:
    • Asthma
    • Chronic obstructive pulmonary disease
    • Diabetes
    • Depression
    • Osteoporosis
    • Chronic heart failure
    • Cardiovascular disorders such as high blood pressure, high cholesterol or coronary artery disease, and
  3. You reach $4,044 in yearly prescription drug costs paid by you and the plan.

Your participation is voluntary, and does not affect your coverage. The program is no cost to you and is open only to those who are invited to participate. The program is not a benefit for all plan members.

What services are included in the program?

The program provides you with a:

Comprehensive Medication Review
The review is a one-on-one discussion with a pharmacist, to answer questions and address concerns you have about the medications you take, including:

The pharmacist will offer ways to manage your conditions with the medications you take. If more information is needed, the pharmacist may contact your prescribing doctor. The review takes about 30 minutes and is usually offered once each year — if you qualify. At the end of your discussion, the pharmacist will provide you a Personal Medication List with the medications you discussed during your review.

You will also receive a Medication Action Plan. Your plan may include suggestions from the pharmacist for you and your doctor to discuss during your next doctor visit.

Here is a blank copy of the Personal Medication List for tracking your prescriptions.

Targeted Medication Review
With this review, we mail, fax or call your doctor with suggestions about prescription drugs that may be safer, or work better than your current drugs. As always, your prescribing doctor will decide whether to consider our suggestions. Your prescription drugs will not change unless you and your doctor decide to change them. We may also contact you, by mail or phone, with suggestions about your medications.

How will I know if I qualify for the program?

If you qualify, we will mail you a letter. Also, you may receive a call, inviting you to participate in this one-on-one medication review.

Who will contact me about the review?

You may receive a call from a pharmacy where you recently filled one or more of your prescriptions. You will be given the option to choose an in-person review or a phone review.

You may be contacted by a call center pharmacist to provide your review, and ensure that you have access to the service if you want to participate. These reviews are conducted by phone.

Why is a review with a pharmacist important?

Different doctors may write prescriptions for you without knowing all the prescription drugs and/or OTC medications you take. For that reason, a pharmacist will:

How do I benefit from talking with a pharmacist?

How can I get more information about the program?

Please contact us if you would like additional information about our program, or if you do not want to participate after being enrolled in the program. Our number is 1-844-635-3406, 24 hours a day, 7 days a week. (TTY users, call 711), Monday – Friday, 8am to 8pm CST.

You can also contact our Customer Services Department at 918-594-5202 or 1-800-333-3275 if you have any questions. Our representatives are available Monday through Friday from 8am to 8pm, CST. From October 1, 2018 through March 31, 2019, Customer Services hours will include Saturdays, Sundays and some Holidays. TTY/TDD users should call 1-800-722-0353.

If you would like to contact CommunityCare Prescription Drug Plan via mail, please use the following address:

CommunityCare Prescription Drug Plan
P.O. Box 340
Tulsa, OK 74101-0340

You can also get information about the Medicare program and Medicare health plans by visiting www.medicare.gov on the Web or by calling 1-800-MEDICARE (1-800-633-4227). Medicare customer service representatives are available 24 hours a day, seven days a week to answer questions about Medicare. TTY/TDD users should call 1-877-486-2048.