How to Prepare for a Medicare Annual Medication Review: Step-by-Step Guide for Seniors

Every year, millions of Medicare beneficiaries get a free, one-on-one review of all their medications. It’s called a Medicare Annual Medication Review, or Comprehensive Medication Review (CMR). But here’s the catch: if you don’t show up prepared, you waste your time-and maybe your health.

Most people think the pharmacist will just look at their prescriptions and say, "Everything looks good." But that’s not how it works. The pharmacist needs to see everything you’re taking-prescriptions, over-the-counter pills, vitamins, herbal teas, even that fish oil you started last winter. If you forget something, or guess a dose, you could miss a dangerous interaction, pay more than you need to, or keep taking a drug that’s no longer helping you.

Here’s the truth: the CMR is only as good as the information you bring. Studies show that when seniors come prepared, satisfaction jumps from 42% to 78%. One woman in Ohio caught a deadly interaction between her blood thinner and a common supplement just by writing down every pill she took. Another man saved $800 a year after his pharmacist spotted a cheaper, equally effective alternative to his cholesterol med.

Who Qualifies for a Medicare Annual Medication Review?

Not everyone gets invited. Medicare Part D plans are required to offer this review, but only to people who meet specific criteria. As of 2025, you’re eligible if you have:

• At least three chronic health conditions (like diabetes, heart disease, COPD, or high blood pressure)
• Take four or more Part D-covered prescription medications (including maintenance drugs)
• Spent at least $1,623 out-of-pocket on covered Part D drugs in the past year

That’s a big change from just a few years ago. In 2023, the cost threshold was over $4,000. Now, more seniors qualify-especially those on multiple generics or who pay for brand-name drugs without insurance help. If you’re unsure, call your Part D plan’s member services. They’ll tell you if you’re targeted for a review this year.

Even if you don’t qualify, ask anyway. Some plans offer reviews to others on a case-by-case basis, especially if you’ve been hospitalized or had a recent change in meds.

What Happens During the Review?

The CMR isn’t a quick chat at the pharmacy counter. It’s a 30- to 60-minute appointment-usually by phone or video call-with a licensed pharmacist trained in medication therapy management. They’ll go through every single thing you take, including:

• All prescription drugs (even ones from different doctors)
• Over-the-counter meds (pain relievers, sleep aids, antacids)
• Vitamins and supplements (iron, magnesium, melatonin)
• Herbal remedies (ginkgo, garlic pills, turmeric)
• Topical creams or patches (like nicotine or pain patches)

The pharmacist checks for:

• Duplicate prescriptions (two drugs that do the same thing)
• Drug interactions (what happens when meds clash)
• Side effects you haven’t mentioned
• Medications you no longer need
• Cost-saving alternatives
• Adherence problems (like skipping doses because pills are too expensive or confusing)

At the end, you’ll get three documents in the mail:

1. Consultation Letter - Summarizes what was discussed
2. Medication Action Plan - Lists changes or next steps (like stopping a drug or switching brands)
3. Personal Medication List - Your updated, official list to keep and share with all your doctors

This isn’t just paperwork. It’s your personal medication roadmap. Keep it with your other health records. Bring it to every doctor visit.

How to Prepare: The 5-Step Checklist

You can’t wing this. Preparation turns a routine call into a life-changing conversation. Here’s exactly what to do.

Step 1: Gather Every Medication You Take

Don’t rely on memory. Go through every cabinet, purse, nightstand, and medicine drawer. Collect every pill bottle, box, or packet-even the ones you haven’t used in months. You need the original containers, not just a list. Why? Because labels show the exact name, dose, and instructions. A bottle of “ibuprofen” could be 200 mg or 800 mg. The pharmacist needs to see the label.

Pro tip: Take photos of each label with your phone. That way, if you misplace something, you still have the info. You can even use a free app like Medisafe or MyTherapy to snap and store them.

Step 2: Make a Realistic Medication List

Write down:

• Drug name (as it appears on the bottle)
• Dose (e.g., 10 mg, 500 mg)
• How often you take it (once daily, twice a day, as needed)
• Why you take it (e.g., “for blood pressure,” “for arthritis pain”)
• When you started taking it (if you remember)

Include everything-even the stuff you think doesn’t matter. That gummy vitamin with melatonin? The turmeric capsule your daughter gave you? The OTC laxative you use every few weeks? Write it all down. Studies show people forget 2 to 3 medications on average when they just list them from memory.

Use a simple table:

Step 3: Note Your Concerns

Write down three to five questions or worries. Examples:

• “I feel dizzy after I take my blood pressure pill-should I take it at night instead?”
• “I’ve been forgetting to take my pills. Is there a simpler way?”
• “My cholesterol med costs $120 a month. Is there a cheaper one?”
• “I take six pills at breakfast. Is that too many?”
• “I started taking ginger capsules for joint pain. Is that safe with my blood thinner?”

Don’t hold back. If something feels off, say it. The pharmacist isn’t there to judge-they’re there to fix problems you didn’t even know you had.

Step 4: Bring Recent Health Changes

Did you recently:

• Go to the ER or get hospitalized?
• Start seeing a new doctor?
• Have a fall or change in mobility?
• Notice new symptoms like confusion, fatigue, or swelling?

Bring notes on these-even if they seem unrelated. A change in balance might be caused by a drug interaction. Memory lapses could be from an old antihistamine you’re still taking. Your pharmacist connects the dots between meds and symptoms that your doctor might miss in a 10-minute visit.

Step 5: Bring Someone With You

It’s not just helpful-it’s smart. Bring a family member, friend, or caregiver. You’ll be talking about complex medical info. You might forget something. You might feel overwhelmed. A second set of ears helps. They can also ask questions you didn’t think of.

One man in Florida brought his daughter. She noticed he was taking two different blood thinners-one prescribed by his cardiologist, another by his orthopedist. They’d never told each other. That interaction could have caused internal bleeding.

What to Expect During the Call

The pharmacist will start by confirming your list. They’ll ask:

• “Do you take this every day, or only when you need it?”
• “Have you noticed any side effects?”
• “Do you ever skip doses because of cost?”
• “Do you use a pill organizer?”

They’ll check for red flags:

• Drugs that shouldn’t be taken together (like NSAIDs and blood thinners)
• Medications that lose effectiveness over time
• Drugs that cause drowsiness and increase fall risk
• Overlapping doses (e.g., taking Tylenol and a cold med that also has acetaminophen)

You’ll get clear answers. No jargon. No rushing. They’ll explain what’s working, what’s not, and what to do next.

What If You’re Not Eligible?

If you don’t meet the criteria but still take multiple meds, you still deserve a review. Ask your pharmacist if they offer a free “medication check-up.” Many community pharmacies do. Or ask your doctor for a referral to a medication therapy management program. You can also schedule a Medication Therapy Management session through your Part D plan-even if you’re not automatically targeted.

Some plans now let you request a CMR yourself. Call customer service and say: “I’d like to schedule a Comprehensive Medication Review, even though I’m not on the list.” They can’t refuse if you’re a Part D member.

After the Review: What to Do Next

Don’t just file the documents and forget them.

• Keep your updated Personal Medication List in your wallet or phone.
• Share it with every new doctor, specialist, or hospital you visit.
• Review it every three months. Add new meds. Remove old ones.
• If you get a new prescription, call your pharmacist before filling it. Ask: “Is this safe with what I’m already taking?”

One woman in Arizona kept her list on her fridge. When she fell and went to the ER, the nurses used it to avoid giving her a drug that interacted with her heart med. She credits that list with saving her life.

Common Mistakes to Avoid

Here’s what most people do wrong:

• Bringing only prescriptions - OTC meds and supplements cause half of all dangerous interactions.
• Guessing doses - “I take one of those little white pills.” That’s not enough.
• Not mentioning side effects - “I’m just tired” might mean your meds are too strong.
• Waiting until the last minute - If you wait for the call, you might miss it. Call your plan proactively.
• Thinking it’s not worth it - 87% of seniors who prepared well said the review changed their medication plan for the better.

Don’t be the person who gets rescheduled because they didn’t bring their pill bottles. That’s the #1 complaint on Medicare.gov reviews.

Final Thought: This Is Your Health

The Medicare Annual Medication Review isn’t a bureaucratic formality. It’s your chance to take control. You’re not just a patient-you’re the expert on your own body. You know when something feels off. You know what you can afford. You know what helps you sleep or what makes you dizzy.

This review is designed to listen to you. But only if you speak up.

Take 45 minutes. Gather your meds. Write down your questions. Bring someone you trust. Show up ready. You could prevent a hospital stay, save hundreds of dollars, or even avoid a life-threatening interaction.

That’s not just good healthcare. That’s smart living.