Medication Therapy Management (MTM) Program

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

  • Preventing or reducing drug-related risks
  • Increasing your awareness
  • Supporting good habits

Who qualifies for the program?

We will automatically enroll you in the CommunityCare Options 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
    • Chronic heart failure
    • Dyslipidemia
    • Hypertension
    • Chronic Alcohol and Other Drug Dependence
    • HIV/AIDS, and
  3. You reach $5,330 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 and a
  • Targeted medication review

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:

  • Prescription drugs
  • Over-the-counter (OTC) medicines
  • Herbal therapies
  • Dietary supplements and vitamins

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 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:

  • Discuss how your prescription drugs and OTC medications may affect each other
  • Identify any prescription drugs and OTC medications that may cause side effects and offer suggestions to help
  • Help you get the most benefit from all of your prescription drugs and OTC medications
  • Review opportunities to help you reduce your prescription drug costs

How do I benefit from talking with a pharmacist?

  • Discussing your medications can result in real peace of mind knowing that you are taking your prescription drugs and OTC medications safely
  • The pharmacy can look for ways to help you save money on your out-of-pocket prescription drug costs
  • You benefit by having a Personal Medication List and a Medication Action Plan to keep and share with your doctors and health care providers

How do I safely dispose of medications I don’t need?

The CommunityCare Options MTM Program is dedicated to providing you with information about safe medication disposal. Medications that are safe for you may not be safe for someone else. Unneeded medications should be disposed of as soon as possible. You can discard your unneeded medications through a local safe disposal program or at home for some medications.

  • Locating a community safe drug disposal site

    A drug take back site is the best way to safely dispose of medications. To find drug take back sites near you, visit the Controlled Substance Public Disposal Locations website and enter your location.

    Some pharmacies and police stations offer on-site drop-off boxes, mail-back programs, and other ways for safe disposal. Call your pharmacy or local police department (non-emergency number) for disposal options near you.

  • Mailing medications to accepting drug disposal sites

    Medications may be mailed to authorized sites using approved packages. Information on mail-back sites can be found at the United States Drug Enforcement Administration website

  • Safe at-home medication disposal

    You can safely dispose of many medications through the trash or by flushing them down the toilet. Visit the US Department of Health and Human Services "How to Safely Dispose of Drugs" webpages first to learn what medications are safe to dispose of at home.

    Steps for medication disposal in the trash:

    • Remove medication labels to protect your personal information
    • Mix medications with undesirable substances, such as dirt or used coffee grounds
    • Place mixture in a sealed container, such as an empty margarine tub

How can I get more information about the program?

Please contact us if you would like more information about the CommunityCare Options MTM Program or if you do not want to participate. Our number is 1-844-635-3406, Monday – Friday, 8 a.m. – 6 p.m. CST (TTY users, call 711).

Please call Customer Service at 918-594-5202 or 1-800-333-3275 if you have any questions. Our Representatives are available Monday through Friday from 8:00 am to 8:00 pm. From October 1, 2023 through March 31, 2024, Customer Service hours will include Saturdays, Sundays and some Holidays. TTY/TDD users should call 1-800-722-0353.

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

CommunityCare Options Customer Service
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, 7 days a week to answer questions about Medicare. TTY/TDD users should call 1-877-486-2048.