Medication Therapy Management (MTM) Program

The Fidelis Care 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

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Medication Therapy Management FAQs

Who qualifies for the program?

We will automatically enroll you in the Wellcare By Fidelis Care 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
    • Depression
    • Osteoporosis
    • Chronic Heart Failure
    • HIV
    • Chronic alcohol and other drug dependencies
    • Cardiovascular disorders such as high blood pressure, high cholesterol or coronary artery disease, and
  3. You reach $4,376 in yearly prescription drug costs paid by you and the plan in 2021 or you reach $4,696 in yearly prescription drug costs paid by you and the plan in 2022.

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. Regardless of the criteria above, you may also be enrolled in the Wellcare By Fidelis Care program if you are an at-risk-beneficiary enrolled in our Drug Management Program.  

What services are included in the program?

The program provides you with:

  • a Comprehensive Medication Review (CMR)
  • a Targeted Medication Review (TMR), and 
  • Information on the safe disposal of prescription drugs

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.


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.


Information on the safe disposal of prescription drugs

Information will be provided to help you safely dispose of unused prescription drugs that are controlled substances. This information will include details on drug take back programs, in-home disposal, and cost-effective means of safe disposal of such drugs.

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 also be contacted by a call center 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 can I get more information about the program?
Our number is 1-800-247-1447 (TTY users, call 711). From October 1 to March 31, you can call us 7 days a week from 8 a.m. to 8 p.m. From April 1 to September 30, you can call us Monday through Friday from 8 a.m. to 8 p.m. A messaging system is used after hours, weekends and on federal holidays.
How do I safely dispose of medications I don’t need?

The Wellcare by Fidelis Care 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 website below and enter your location:

https://apps2.deadiversion.usdoj.gov/pubdispsearch/spring/main?execution=e2s1
 (By clicking this link, you will leave the Fidelis Care website.) 

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 www.deatakeback.com. (By clicking this link, you will leave the Fidelis Care 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 following website to learn more about safe at-home disposal:

https://www.hhs.gov/opioids/prevention/safely-dispose-drugs/index.html (By clicking this link, you will leave the Fidelis Care website.) 



Follow these 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

 

 

Additional Information

Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal.

From October 1 to March 31, you can call us 7 days a week from 8 a.m. to 8 p.m. From April 1 to September 30, you can call us Monday through Friday from 8 a.m. to 8 p.m. A messaging system is used after hours, weekends and on federal holidays.

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Last Updated 10.13.2021