Medication Therapy Management (MTM) Program
If you’re in a Medicare drug plan and you have complex health needs, you may be able to participate in an MTM program.
The MTM program is a service offered by Lagniappe Advantage at no additional cost to you. It is required by the Centers for Medicare and Medicaid Services (CMS). It is not part of your pharmacy benefit.
How do I participate in this program?
To participate, you must meet certain criteria. These are used to identify people who have many chronic diseases and are at risk for related problems. If you meet these criteria, we will send you a letter inviting you to take part in the program. We will also send you information and provide instructions to access the program. Your enrollment in MTM is voluntary. It does not affect Medicare coverage for drugs covered under Medicare. If you do not want to be in the program, please let us know and we’ll take you out of the program. You can leave the program at any time.
To qualify for MTM program, you must
meet one of the two following criteria:
Criteria One
Are enrolled in the Lagniappe Advantage Drug Management Program as an At-Risk Beneficiary (ARB). This program helps members safely use their prescription opioid medications, and other medications that are frequently abused.
Criteria Two
Meet ALL the following criteria:
-
- Have at least 3 of the following conditions or diseases: Alzheimer’s Disease, Bone Disease-Arthritis (including osteoporosis, osteoarthritis, and rheumatoid arthritis), Chronic congestive heart failure (CHF), Diabetes, Dyslipidemia, End-Stage Renal Disease (ESRD), Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), Hypertension, Mental Health (including depression, schizophrenia, bipolar disorder, and other chronic/disabling mental health conditions), Respiratory Disease (including asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders)
- AND, take at least 8 covered Part D medications
- AND, are likely to have greater than $1,276 per year in 2026 covered Medicare Part D medication costs.
What services does the MTM program offer?
To help reduce the risk of possible medication problems, the MTM program offers two types of clinical review of your medications:
Targeted Medication Review (TMR)
At least every three months, we will review all your prescription medications and may contact your doctor if we identify a potential problem.
Comprehensive Medication Review (CMR)
At least once per year, we offer a free discussion and review of all your medications by a clinician or other health professional to help you use your medications safely. This service is provided to you confidentially on behalf of Lagniappe Advantage via telephone by a Navitus Clinical Engagement Center clinician. The CMR may also be provided in person at your provider’s office, pharmacy, or long-term care facility. The process takes about 20-30 minutes of your time. Afterwards, you will receive a written summary of the CMR, which can be helpful when you talk with your doctors. It includes:
- Recommended To-Do-List (TDL) (also known as Medication Action Plan (MAP)): The TDL has steps you should take to help you get the best results from your medications.
- Personal Medication List (PML): The PML will help you and your health care providers keep track of your medications. It explains how to use your medications the right way.
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:
Download Personal Medication List Template
Next Steps
If you take several medications for multiple chronic health conditions, please contact us to see if you’re eligible. You can call the Navitus Medication Therapy Management (MTM) program team at 1-888-913-7885, Monday through Thursday from 8 a.m. to 7 p.m. Central Time, and Friday from 8 a.m. to 5 p.m. Central Time. TTY users can reach our program team through the National Relay Service 711, during the same hours as shown above.
@2025 Lagniappe Advantage. All rights reserved.
CMS ID Number: H6566_Website,Last modified: March 16, 2026