How to Prepare for a Medicare Annual Medication Review

Every year, millions of Medicare beneficiaries get a chance to sit down with a pharmacist and review every single pill, supplement, and over-the-counter medicine they’re taking. This isn’t just a quick chat-it’s a Medicare Annual Medication Review, also called a Comprehensive Medication Review (CMR). And if you’re on Part D and take multiple medications, this could be one of the most important health appointments you’ll have all year.

Many people think their doctor handles all their medication questions. But doctors see you for 10-15 minutes at most. Pharmacists? They spend 45 to 60 minutes with you, going through every bottle you have, checking for dangerous combinations, asking why you skip doses, and even finding cheaper alternatives. The goal? Keep you safe, stop unnecessary side effects, and save you money.

Who Qualifies for a Medicare Annual Medication Review?

You don’t automatically get this review just because you have Medicare. There are specific rules. As of 2025, you qualify if you:

• Have at least three chronic conditions like diabetes, heart disease, high blood pressure, COPD, or kidney disease
• Take at least eight Medicare Part D-covered prescription medications (including maintenance drugs like insulin, blood pressure pills, or cholesterol meds)
• Spent at least $1,623 out of pocket on those medications in the past year

That last number matters. If you’re paying more than $1,623 a year for your prescriptions, you’re eligible-even if you don’t have eight pills. CMS updated this threshold in 2025 to include more people. Some plans also now consider people with two chronic conditions if they’re at high risk, like those recently discharged from the hospital.

But here’s the catch: you might qualify and still not get contacted. Plan sponsors have 60 days after you enroll to reach out, but many don’t follow up unless you remind them. Don’t wait. Call your Part D plan’s member services and ask, “Am I eligible for a Comprehensive Medication Review this year?”

What’s Actually Covered in the Review?

The review isn’t just about prescription drugs. It includes everything you take:

• All prescription medications (even if they’re not covered by Part D)
• Over-the-counter pills like ibuprofen, antacids, or sleep aids
• Vitamins and supplements (especially fish oil, ginkgo, or St. John’s wort)
• Herbal remedies and home treatments
• Topical creams or patches (like pain patches or nicotine patches)

The pharmacist will check for:

• Duplicate medications (two drugs that do the same thing)
• Drug interactions (like blood thinners mixing with herbal supplements)
• Side effects you haven’t told anyone about
• Medications you might not need anymore
• Costly alternatives that work just as well
• Adherence issues (why you skip doses or run out early)

They’ll also give you three documents after the review:

1. Consultation Letter - A summary of what was discussed
2. Medication Action Plan - A clear list of changes, like stopping a pill or switching to a cheaper version
3. Personal Medication List - An updated, easy-to-read list of everything you take, with doses and times

You keep these. Give them to your doctor. Put them in your wallet. Show them to emergency responders if you’re ever hospitalized.

Why Most People Miss the Point (And How to Avoid It)

Studies show that 78% of people who come prepared say the review was helpful. Only 42% of those who showed up with no list or bottles felt it was useful.

Why? Because people think, “I know what I take.” But most don’t. A 2023 study found that on average, patients forget or misreport 2-3 medications during these reviews. One woman thought she took only four pills a day. When she brought her bottles, it turned out she was taking eight-plus a daily aspirin, a sleep aid, and turmeric capsules. That’s 11 substances. Three of them raised her blood pressure.

Don’t be that person. Here’s how to prepare properly.

How to Prepare: A Step-by-Step Guide

Set aside 60-90 minutes the week before your appointment. Don’t rush it.

1. Gather every medication you take - Put all pills, liquids, patches, creams, and supplements in one place. Use the original bottles. Don’t rely on memory or pill organizers. The pharmacist needs to see the label-dosage, frequency, and prescriber name.
2. Take photos of each label - If you can’t bring the bottles (too many, too heavy), take clear photos. Make sure the text is readable. Include the pharmacy name and phone number.
3. Write down your concerns - What’s bothering you? “I feel dizzy after my blood pressure pill.” “I can’t afford this new antidepressant.” “I take my insulin at night but forget sometimes.” Write it all down. Even small things matter.
4. Check your recent health changes - Did you go to the ER last year? Get a new diagnosis? Have lab work done? Bring those results. Changes in kidney or liver function can affect how your body handles meds.
5. Create a timeline - List each medication and when you started it. Did your doctor change your dose in March? Did you stop a pill in June? Write it out. This helps the pharmacist spot patterns.
6. Bring someone with you - A spouse, child, or friend. People forget things under pressure. Two sets of ears are better than one.

Pro tip: Use the free Medicare.gov Medication Tracker tool to build your list ahead of time. Print it out. Bring it with you.

What to Ask During the Review

You’re not just listening-you’re leading. Come with questions:

• “Is this medicine still necessary? I’ve been on it for years.”
• “Are there cheaper options? My copay went up again.”
• “Could this be causing my fatigue or confusion?”
• “Is this supplement safe with my heart medication?”
• “What happens if I skip a dose?”
• “Can you help me simplify this? I’m taking 12 pills a day.”

Don’t be shy. Pharmacists are trained to help. They’ve seen it all. If they say, “That’s normal,” ask, “But is it safe for me?”

Real Stories: What Happens When People Prepare

One man in Ohio was taking two different blood pressure pills that did the same thing. He didn’t know. His pharmacist caught it and switched him to one cheaper pill. He saved $180 a month.

A woman in Florida was taking melatonin, ginkgo, and fish oil-all for sleep and memory. The pharmacist found they were increasing her risk of bleeding because she was on warfarin. She stopped the supplements and switched to a safer sleep aid. No more bruising.

Another senior in Texas was skipping her diabetes meds because she couldn’t afford them. The pharmacist connected her with a patient assistance program. Her copay dropped from $75 to $0.

These aren’t rare cases. They’re the norm-when people show up prepared.

What If You Don’t Qualify?

Even if you don’t meet the Medicare CMR criteria, you can still ask for a medication review. Most pharmacies offer free consultations. Walk in with your list. Ask, “Can you review my meds for interactions or costs?” Many pharmacists will do it, especially if you’re a regular customer.

Some community health centers and senior centers also offer free medication reviews. Call your local Area Agency on Aging. They often partner with pharmacists to help older adults.

And if you’re on Medicaid or dual-eligible (Medicare and Medicaid), you may qualify for an even more thorough review called a Medication Therapy Management (MTM) program-sometimes with more frequent check-ins.

What Happens After the Review?

You’ll get your three documents in the mail within 10-14 days. Don’t ignore them.

• Review the Medication Action Plan. If they recommend stopping a drug, talk to your doctor first. Don’t quit cold turkey.
• Update your Personal Medication List and keep it with you. Update it every time you get a new prescription.
• Call your pharmacy if you don’t get your documents. Sometimes they get lost.
• Set a reminder for next year. The review is annual, but your meds change all the time.

Some plans now offer telehealth CMRs. If you’re comfortable on Zoom, ask if that’s an option. It’s just as effective-and saves you a trip.

Why This Matters More Than Ever

By 2026, over 65% of eligible Medicare beneficiaries are expected to get their annual review. That’s up from 57% in 2022. Why? Because it works. CMS data shows that people who complete a CMR have 22% fewer hospital visits related to medication problems. They spend less on unnecessary drugs. They live better.

But it only works if you show up ready. This isn’t a test. It’s your health. You’re not just a patient-you’re the expert on your own body. The pharmacist is there to help you connect the dots.

Don’t wait for them to call. Don’t hope it’ll be “good enough.” Take 90 minutes now to gather your pills, write your questions, and bring your list. Your future self will thank you.