PDP Medication Therapy Management Program (2014)

For Basic (PDP) plan

Health First Health Plans is excited to offer a Medication Therapy Management (MTM) Program at no additional cost for our qualified Medicare members. This program is not considered a covered benefit but is an extra service we provide to improve your care. Our MTM program is designed to assist members who may benefit from added support with their Part D drug benefits. The MTM program was developed by a team of pharmacists and doctors to offer support services beyond traditional pharmacy dispensing and counseling.

We use criteria established by Medicare to identify eligible members. A few of these guidelines include members who have multiple medical conditions, who are filling at least 7 prescription drugs per month, and/or who have high drug costs. A qualified member must accumulate drug costs exceeding $754 in one quarter or have documented illnesses in at least 3 of the following chronic conditions:

  • Asthma
  • Chronic Heart Failure
  • Diabetes
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Cancer
  • Hypertension
  • Bone Disease/Arthritis/Rheumatoid Arthritis
  • Alzheimer's Disease

We will automatically enroll qualified members in Health First Health Plans’ MTM program so they may begin receiving this extra support. Although we encourage members to take advantage of our valuable program, you do have the option to opt out of the program. You may opt out by signing the bottom of your MTM enrollment form and mailing it back to Health First Health Plans at 6450 US Highway 1 Rockledge, FL. 32955. The MTM enrollment form will be mailed to each member who is automatically enrolled into the program. Remember, to participate in this supportive program, you do not need to do or pay anything additional.

While enrolled in the program, you will receive several additional services to include:

  • Consultations with a pharmacist
  • Face to face medication counseling
  • Telephone consultations and social support
  • Educational mailings

For questions or to receive additional information about the Health First Health Plans MTM program, please contact Customer Service.

Y0089_MP3686 Approved 2/3/2014
Last updated: 10/1/2013