Medicare Advantage Medication Therapy Management Program (2018)

For our Classic (HMO-POS), Rewards (HMO), Value (HMO) and Employer Group plan members

Some of our Medicare members take medications prescribed by more than one doctor, or they take several different prescriptions. Combining these medications could:

  • Reduce their effectiveness
  • Cause severe side effects
  • Cost you more money than necessary

Health First Health Plans offers a Medication Therapy Management (MTM) Program at no additional cost to ensure your medications are working together to improve your health.

Our MTM program is designed to assist Medicare members who have multiple medical conditions, are filling at least eight prescription drugs per month and/or have high drug costs.

To qualify for this assistance, the member must accumulate drug costs exceeding $991.75 in one quarter and have at least three of the following chronic conditions: Chronic Heart Failure, Chronic Obstructive Pulmonary Disease (COPD), Diabetes, Dyslipidemia or Hypertension.

Members who meet these criteria are automatically enrolled in our MTM program. We automatically mail all eligible members an MTM enrollment form. If you would like to decline participating in the program, you may do so by signing the opt-out section at the bottom of the enrollment form and mailing it back to us at Health First Health Plans, 6450 US Highway 1 Rockledge, FL. 32955.

What Our MTM Program Services Include

Targeted Medication Reviews: Assessments that focus on key drug therapy problems and/or medication safety concerns. You or your healthcare provider may be contacted as a result of a Targeted Medication Review. This type of review lasts approximately 10 minutes and can be conducted by phone or in person.

Comprehensive Medication Reviews: A 30-minute consultation by phone or in person with a pharmacist or other qualified health professional, who will review all of your medications and talk with you about:

  • Why each medication is prescribed
  • Whether any medications are potentially unnecessary
  • How well your medications are working
  • Whether your medications have side effects
  • If there might be drug interactions between the drugs you’re taking
  • Whether your costs can be lowered
  • If another medication could benefit your health
  • If there are issues that prevent you from taking your medication, such as transportation to the pharmacy, side effects or costs

After your Comprehensive Medication Review, you will receive:

  • A Medication Action Plan: This will include steps you should take to get the best results from your medications.
  • A Personalized Medication List: This go-to guide will help you keep track of the prescriptions you’re taking and how to use them properly. Click here for a blank list to track additional medications.

For more information about the Health First Health Plans MTM program, please contact Customer Service.


Y0089_MP6562 APPROVED 10/5/2017