Medication therapy management

What it means

Every Medicare Part D plan must run one, must enroll qualifying members by opt-out rather than application, and must look for people to enroll at least quarterly.

The minimum service includes an annual comprehensive review of the whole medicine list, delivered as an interactive consultation with a pharmacist in person or by video, with a written summary and often an action plan.

Where the member cannot take part because of cognitive impairment, the review may be done with the prescriber, the caregiver or another authorized person instead.

Why it matters

It is the service families are looking for when they say somebody should look at all the pills at once, and it is already paid for.

Because enrollment is by opt-out, a parent who qualifies is already in it and has probably ignored the letter.

When you are likely to meet it

• When a parent is taking many medicines prescribed by several people who do not talk to each other.
• After a hospital stay, when the list has changed and nobody has reconciled it.

Related terms

• Discharge plannerThe hospital staff member responsible for what happens after a stay ends.
• MedicareThe federal health insurance program for people aged sixty-five and over, and for some younger people with disabilities. It does not pay for long-term care.
• Medicare Part DMedicare's prescription drug coverage, bought as a separate plan from a private insurer.
• Memory careResidential care designed for dementia — secured, higher-staffed, and more expensive than ordinary assisted living.
• PolypharmacyTaking enough different medicines that the combination becomes a risk in its own right.

Official sources

The authority this page describes, at the agency that publishes it. Sahvelo does not restate a rule from a secondary source.

• Medicare — medication therapy management programs (opens in a new tab)

Sahvelo guidance that uses this

• Medication