CareAdvantage Dual Eligible Special Needs Plan (D-SNP) 2026

Medication Therapy Management (MTM) Program

Medication Therapy Management (MTM) is a special program you may be enrolled in if you meet certain criteria. The program makes sure your medicines are safe and work well for you. We partner with licensed pharmacists from MedWatchers to provide this service for you at no cost. MTM is about making sure your medicines are safe, helping you understand them better, and making a plan to keep you healthy.

Comprehensive Medication Review and Targeted Medication Review)

If you are enrolled in MTM, here's what it means and how it can help you:

• You will receive a letter welcoming you to the program and giving you important information on how to schedule a comprehensive medication review (CMR) with a MedWatchers pharmacist.
• The CMR can be done over the phone or via telehealth and will take about 20-30 minutes to complete.

• During the CMR, the MedWatchers pharmacist will:
  1. Look at all the medicines you’re taking, even the ones you buy without a prescription. 
  2. Talk to you about why you take each medicine and what they do.
  3. Ask about any problems you are having with your medicines.
  4. Make suggestions on ways to save you money, medicines you may no longer need, and what medicines are important to keep you healthy.
  5. Answer any questions you may have.
  6. Work with your doctors and other healthcare providers to make sure you are taking the medicines that are best for you.
• You will receive a summary of the CMR in the mail within 14 days of completing the CMR which includes your to-do list and your personal medication list.
• You should also keep a current list of your medications handy when talking with any healthcare providers. Here is a blank copy of a medication list for you to print and fill out.
• This isn’t just a one-time thing. When you are in the MTM program, MedWatchers will keep checking on your medicines at least once a quarter through our targeted medication review (TMR) process to make sure they’re still right for you. If we notice any concerns, we will either contact you by phone for a quick 5-10 minute conversation, or we may make recommendations to your provider to adjust your medicines as needed.

Program Eligibility

This program is only available to you if you meet certain criteria. For 2026, you must meet all of the following to be enrolled:

1. You are likely to spend more than $1,276 in 2026 on Part D prescription medications
2. You are taking 8 or more maintenance Medicare Part D drugs on a regular basis
3. You have 3 or more of the following conditions:
   1. Alzheimer’s Disease
   2. Bone Disease/Arthritis (including osteoporosis, osteoarthritis, and rheumatoid arthritis)
   3. Chronic congestive heart failure (CHF)
   4. Diabetes
   5. Dyslipidemia
   6. End-Stage Renal Disease (ESRD)
   7. Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS)
   8. Hypertension
   9. Mental health (including depression, schizophrenia, bipolar disorder, and other chronic/disabling mental health conditions)
   10. Respiratory Disease (including asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders)

OR, you can also qualify for the MTM program if you are an at-risk beneficiary (ARB) enrolled in a Drug Management Program (DMP).