Are drugs for morbid obesity covered by Part D?

Yes, despite the fact that drugs for weight loss or weight gain are specifically excluded from Part D, drugs used to treat morbid obesity will be covered by Part D unless they are otherwise excluded.  A list of drugs specifically excluded by the MMA is located at: What Drugs Are NOT Part D-Covered Drugs?

Source: The Preamble to the MMA Regulations specifically addresses the topic of Part D coverage of drugs used to treat morbid obesity.

Drugs that are excluded from coverage under Part D when used as agents for certain conditions may be considered covered when used to treat other conditions not specifically excluded by section 1927(d)(2) of the Act, provided they otherwise meet the requirements of section 1860D–2(e)(1) of the Act and are not otherwise excluded under section 1860D–2(e)(2)(B) of the Act. To the extent this is the case, and a drug is dispensed for a ''medically accepted indication'' as described in the statute, weight loss agents may be covered for the treatment of morbid obesity, and decongestant products for example, may be covered when used to treat allergies. However, we clarify that Part D plans may establish utilization management processes in order to ensure that such drugs are being prescribed for medically accepted indications that are not excluded under section 1927(d)(2) of the Act (for example, decongestant products when used for ''symptomatic relief of coughs and colds’’).

(Back to Medicare Drug Coverage: Formulary)