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Eligibility & Enrollment
Medication Therapy Management (MTM) Program
Our Medication Therapy Management Program can help find any possible errors or gaps in your prescription drug care.
What is the Medication Therapy Management Program?
The Medication Therapy Management (MTM) Program is a part of Cigna HealthcareSM Medicare Part D Prescription Drug Plans and Cigna Healthcare Medicare Advantage Plans (Part C) with prescription drug coverage.
MTM can help find any possible errors and gaps in your care by:
- Lowering the risk of medication errors, especially if you have chronic conditions, take many medications, or see multiple doctors
- Giving information on proven medical practices to help you and your doctor decide the most effective treatment
- Helping you understand your condition and medications, so you can take an active role in taking care of your health
How do I qualify?
There are two ways to qualify for program assistance and be enrolled in the MTM program.
The first way to qualify for program assistance is if you meet all three of the following criteria:
1. Medical Conditions: You have at least three of the following medical conditions:
- 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)
2. Medications: You take at least 8 maintenance Part D prescription drugs.
3. Drug Spend Threshold: Your prescriptions for the last three months cost more than one-fourth of the yearly cost level. The Centers for Medicare & Medicaid Services (CMS) set a cost level each year. The 2024 cost level is $5,330. The 2025 cost level is $1,623.
The second way to qualify for program assistance is if you are identified as an At-Risk Beneficiary (ARB) under the plan’s Drug Management Program (DMP) for potential misuse of opioid medications.
How do I get started?
Cigna Healthcare Medicare customers who qualify for the MTM Program are automatically enrolled1 and sent a welcome packet in the mail.
Based on the guidelines above, all chosen customers will be offered a full comprehensive medication review (CMR) by a clinical pharmacist at least yearly. The average call time for the medication review is 20 minutes, but our pharmacists will take as much time as needed to answer all of your questions. The CMR is an interactive session with one of our clinical pharmacists to talk about all medications, such as:
- Prescription
- Over-the-counter (OTC) medications
- Herbal therapies
- Dietary supplements
After the medication review, you'll get an individualized letter in the mail. Each letter has a personal medication record of all medications discussed and a plan of action, if needed. Your prescriber may also get a letter after your CMR with possible interventions to solve medication-related problems or other ways to optimize medication use. Also, we automatically complete targeted medication reviews (TMRs) each quarter if eligible and mail your prescriber(s) a letter with intervention opportunities.
Getting involved in the MTM Program may help improve your health and lower your risk for medication reactions, hospitalization, and emergency room visits. Depending on your diagnosis, it may help improve your cholesterol and blood sugar levels, and lower your risk of heart attack.
How much will this program cost me?
There is no extra cost for this program. While it’s not seen as a Medicare benefit, the MTM Program is part of the plan you select for coverage.
How can I safely dispose of my medications?
You will receive information on how to safely dispose of your medications in your welcome packet. It’s important to get rid of unwanted medications in a way that won’t endanger others. Drop off unwanted medications at certain authorized pharmacies and collection sites on National Prescription Drug Take Back Day or go to approved locations anytime throughout the year.
What if I have questions?
If you have questions or need more information, please call the Cigna Healthcare Medicare MTM Program toll-free:
Medicare Advantage Plans (Part C)
Medicare Part D Prescription Drug Plans
Appointments are available Monday - Friday, 8 am - 6 pm ET. For questions about health plan benefits, coverage issues, or claims, please contact us.
1 Unless you opt-out of enrolling in the program.
The Medication Therapy Management (MTM) Program is a component of Cigna Healthcare Medicare prescription drug plans and should not be considered a Medicare benefit. MTM is neither offered nor guaranteed under our contract with the Medicare program and is not subject to the Medicare appeals process.
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Medicare Advantage and Medicare Part D Policy Disclaimers
Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group. The Cigna Healthcare names, logos, and marks, including THE CIGNA GROUP and CIGNA HEALTHCARE are owned by The Cigna Group Intellectual Property, Inc. Subsidiaries of The Cigna Group contract with Medicare to offer Medicare Advantage HMO and PPO plans and Part D Prescription Drug Plans (PDP) in select states, and with select State Medicaid programs. Enrollment in a Cigna Healthcare product depends on contract renewal.
To file a marketing complaint, contact Cigna Healthcare or call 1-800-MEDICARE (
Medicare Supplement Policy Disclaimers
Medicare Supplement website content not approved for use in: Oregon.
AN OUTLINE OF COVERAGE IS AVAILABLE UPON REQUEST. We'll provide an outline of coverage to all persons at the time the application is presented.
Our company and agents are not connected with or endorsed by the U.S. Government or the federal Medicare program. This is a solicitation for insurance. An insurance agent may contact you. Premium and benefits vary by plan selected. Plan availability varies by state. Medicare Supplement policies are underwritten by American Retirement Life Insurance Company, Cigna Health and Life Insurance Company, Cigna Insurance Company, Cigna National Health Insurance Company or Loyal American Life Insurance Company. Each insurer has sole responsibility for its own products.
The following Medicare Supplement Plans are available to persons eligible for Medicare due to disability: Plan A in Arkansas, Connecticut, Indiana, Maryland, Oklahoma, Rhode Island, Texas, and Virginia; Plans A, F, and G in North Carolina; and Plans C and D in New Jersey for individuals aged 50-64. Medicare Supplement policies contain exclusions, limitations, and terms under which the policies may be continued in force or discontinued. For costs and complete details of coverage, contact the company.
This website is designed as a marketing aid and is not to be construed as a contract for insurance. It provides a brief description of the important features of the policy. Please refer to the policy for the full terms and conditions of coverage.
In Kentucky, Plans A, F, G, HDG, N are available under Cigna National Health Insurance Company, Plans A, F, G, HDF, N are available under Cigna Health and Life Insurance Company and Plans A, B, C, D, F, G, N are available under Loyal American Life Insurance Company.
Kansas Disclosures, Exclusions and Limitations
Medicare Supplement Policy Forms: Plan A: CIC-MS-AA-A-KS, CIC-MS-AO-A-KS; Plan F: CIC-MS-AA-F-KS, CIC-MS-AO-F-KS; Plan G: CIC-MS-AA-G-KS, CIC-MS-AO-G-KS; Plan HDG: CIC-MS-AA-HDG-KS, CIC-MS-AO-HDG-KS; Plan N: CIC-MS-AA-N-KS, CIC-MS-AO-N-KS
Exclusions and Limitations:
The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
(1) the Medicare Part B Deductible;
(2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
(3) any services that are not medically necessary as determined by Medicare;
(4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if You were enrolled in Parts A and B of Medicare;
(5) any type of expense not a Medicare Eligible Expense except as provided previously in this policy;
(6) any deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
(7) Preexisting Conditions: We will not pay for any expenses incurred for care or treatment of a Preexisting Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Preexisting Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.