Prime provides Medicare Part D prescription benefit services to over 14 health plans totaling over 800,000 Medicare beneficiaries. Prime works to ensure our network pharmacies have the information they need to provide effective service to all of their beneficiaries. Prime manages the pharmacy network, maintains the formulary, processes pharmacy claims, provides Medication Therapy Management (MTM) services to eligible beneficiaries and performs other PBM services on behalf of its plan sponsors.

Prime is committed to optimizing therapeutic outcomes through improved medication use as well as through the reduction of adverse drug events. Prime has developed an outpatient pharmacy MTM program that provides patients with direct interaction with pharmacists. Pharmacies must be under contract with Prime to provide MTM services to be eligible to receive payment for performing MTM interventions.

Retail Pharmacy MTM Process
Glossary