Medication Therapy Management (MTM) Program

We offer Medication Therapy Management (MTM) programs at no cost to our members who have multiple medical conditions, who are taking many prescription drugs, and who have high drug costs. These programs were developed for us by a team of pharmacists and doctors. We use these medication therapy management programs to help us provide better coverage for our members.

In addition to your medical and prescription drug benefits, this is a free service provided to all FirstCare Advantage Dual SNP (HMO SNP)members who qualify for the program. For example, these programs help us make sure that our members are using appropriate drugs to treat their medical conditions and help us identify possible medication errors.

How do you qualify for the Medication Therapy Management (MTM) program?

  • You must have 3 or more chronic health problems. These may include:
Asthma;
Chronic Heart Failure (CHF);
Chronic Obstructive Pulmonary Disease (COPD);
Depression;
Diabetes;
Alzheimer's Disease;
Dyslipidemia;
Hypertension; and/or
Osteoporosis.
  • You must take 8 or more daily medications that are covered by Medicare Part D.
  • Your Part D covered medication costs more than the CMS annual drug spend. CMS annual drug spend means total annual cost of a beneficiary's covered Part D Drugs is likely to be equal or exceed the specified annual cost threshold ($4,044). This is specific to the MTM program and is different that Part D drug coverage phase amounts.

How can the Medication Therapy Management (MTM) program help me?

The Medication Therapy Management (MTM) program is offered by your health plan. It is designed to help you and your doctor make sure your medicines are working.

If you qualify for the Medication Therapy Management (MTM) program, you will receive:
  • Introductory letter
    • This letter will tell you how to get started.
  • Comprehensive medicine review
    • You will have the chance to review your medicines with a pharmacist or other healthcare provider each year. This review will help you get the best results from your medicines.
    • You will receive a letter that outlines this review and suggests action steps.
  • Targeted medicine review
    • You or your doctor will be told if you should think about any changes in your medicines.
    • You or your doctor may receive information that outlines this review.

How can I learn more about the Medication Therapy Management (MTM) program?

To learn more about the Medication Therapy Management (MTM) program, or to find out if you qualify, please contact FirstCare Advantage Dual SNP (HMO SNP)Customer Service at 1-866-229-4969 (TTY users 1-800-562-5259).
We are available:
October 1 – March 31, 8 a.m. to 8 p.m. Central Time (CT) daily;
April 1 – September 30, 8 a.m. to 8 p.m. Central Time (CT) Monday through Friday.



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Virtual Care Powered by MDLive

We've teamed up with MDLIVE to provide our members with access to Telehealth visits to board-certified doctors, pediatricians, licensed therapists and more- using your smartphone, tablet or desktop.  ***Available January 1, 2019***

Talk to a Nurse—Nurse24™

Need care advice? Should you see a doctor? Get the info you need today! FirstCare members can talk to a nurse 24/7 by calling 1.855.828.1013 to get answers 24 hours a day, 7 days a week! TTY users can call 7-1-1 or  1.800.955.8771. Voice communication is available at 1.800.955.8770.

Utilization Management

Ever wonder how we decide what services to authorize? Our utilization management (UM) decisions are based on medical evidence and consensus of health care professionals. For more details, click here.

How to Learn More

Schedule a sit-down:
Feel free to contact us, and a FirstCare Advantage Dual SNP (HMO SNP) representative will gladly sit down with you and compare the plans in greater detail.
 
Call us at:
1- 866- 229-4969
We are available;
October 1- March 31, 8 a.m. to 8 p.m. Central Time (CT) daily;
April 1- September 30, 8 a.m. to 8 p.m. Central Time (CT) Monday through Friday.
 
For TTY or for accommodation of persons with special needs, please call TTY 1-800-562-5259.
 
Or, write:
FirstCare Advantage Dual SNP (HMO SNP)
Attn:  Customer Service
1901 West Loop 289, Suite 9
Lubbock, TX 79407

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