VNSNY CHOICE has a program designed to help plan members who may have several complex medical conditions, or need to take many drugs at the same time, or have very high drug costs. This program helps members manage their drugs and reduce potential problems. The Medication Therapy Management Program (MTMP) can help you and your doctors get the most benefit from your drugs.
Who Qualifies for the MTMP?
You will be automatically enrolled in this program if you meet all of the following criteria:
- Take eight or more Medicare Part D-covered medications
- Have three or more of the following conditions or diseases: Chronic Heart Failure (CHF), Diabetes, Dyslipidemia, Hypertension, Asthma, or Chronic Obstructive Pulmonary Disease (COPD)
- Likely to spend more than $3,919 a year on your Part D-covered medications
If you qualify, this program is offered at no cost to you. Please note: not all plan members will qualify for the MTMP; therefore, the program is not considered a benefit.
How will I know if I qualify?
Once you qualify, you will receive an invitation to have a Comprehensive Medication Review (CMR) with a MTM provider who will be a pharmacist or other health professional. The MTM provider will review all of the medications you are taking and discuss them with you. A CMR will be offered to you at least once per year, in a confidential telephone call which will require about 30 minutes of your time.
Following the review, you will get a written summary of this call, which you can take with you when you talk with your doctors. This summary includes:
- Medication Action Plan (MAP): The action plan has steps you should take to help you get the best results from your medications.
- Personal Medication List (PML): The Medication list will help you keep track of your medications and how to use them the right way.
Once you are enrolled in the MTMP, your medications will also be reviewed whenever you fill a prescription. You and/or your doctor will be contacted if the quarterly review reveals any potential problems.
How does it work?
This program works with you and your doctor to make sure the drugs you are taking are safe and effective for you. During the CMR, the MTM provider will review all of your drugs and any other medications, including vitamins or herbal supplements. Your doctor may be contacted directly if there is a question about them. When you talk to the MTM provider, he or she can let you know how to better manage your conditions with your drug therapy. The MTM provider will be able to answer any questions and address any concerns that you have about your drugs.
To obtain a blank copy of the Personal Medication List (PML) that can help you and your health care providers keep track of the medications you are taking, please click on the link below:
What if I don't wish to participate in MTMP?
If you would like additional information about this program or you do not wish to take part in the MTMP, please call Member Services at 1-866-783-1444 (TTY for the hearing impaired: 711), 8 am – 8 pm, Monday – Friday.
This is a Medicare-related page; some of the links will take you to non-Medicare information or to a different website.
This information is not a complete description of benefits. Contact the plan for more information.
Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. Some plans are available to anyone who has both Medical Assistance from the State and Medicare. Premium, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
VNSNY CHOICE Medicare Total is an HMO SNP plan with a Medicare contract. This plan is also a Medicaid Advantage Plus plan, with a contract with the New York State Department of Health. Enrollment in VNSNY CHOICE Medicare depends on contract renewal.
Last updated 2/15/2018