Health Assistance Partnership - Helping SHIPS Help Medicare Beneficiaries
Building Your SHIP
Collaborative State Projects
SHIPTools
Volunteer Program Development
Best Practices
SHIP Funding

Charting Your Course
Original Medicare
Medicare Advantage
Medicare Drug Coverage
Medicaid & Low-Income Benefits
Reference Library

Propelling Your SHIP
Consultative Services

Join the HAP Community

What Drugs Are NOT Part D-Covered Drugs?

 

Prescription drugs that are covered by Medicare Part A or Medicare Part B are not covered by Part D plans.  In addition, certain drugs generally may not be covered by a Medicare Drug Plan [1].  These drugs include the following:

  • Drugs prescribed for weight-loss or weight-gain
  • Drugs prescribed for the symptomatic relief of coughs and colds
  • Prescription vitamins, with the exception of prenatal vitamins and fluoride
  • Over-the-counter drugs, with the exception of insulin
  • Prescription drugs to promote hair growth
  • Fertility drugs
  • Cosmetic drugs
  • Drugs that must be monitored by testing services that only the manufacturer provides, such as certain anti-psychotic medications
  • Barbiturates (drugs used to control seizures or used for sedation or anesthesia such as Phenobarbital or Nembutal®)
  • Benzodiazepines, often referred to as minor tranquilizers, used to treat anxiety or insomnia (such as Xanax®, Valium® and Ativan®)
  • Erectile Dysfunction (ED) drugs, when prescribed for the treatment of sexual or erectile dysfunction [2]


[1] Enhanced Medicare Drug Plans may opt to cover non-Part D drugs as an extra benefit.
[2] For Contract Year (CY) 2006 Erectile Dysfunction (ED) drugs met the definition of a Part D drug and were available on Plan Sponsor formularies. On October 26, 2005, Section 1860D-2(e)(2)(A) of the Social Security Act was amended to exclude ED drugs when prescribed for the treatment of sexual or erectile dysfunction, for CY 2007 and beyond. Please see the CMS Q&A on ED drugs for more information.

 

Update Your Profile | Web Features | Privacy Policy | Contact Us | Printer-Friendly Version | Copyright and Terms of Use

Health Assistance Partnership
1201 New York Avenue NW, Suite 1100
Washington, DC, 20005
Phone: 202-737-6340
Fax: 202-737-8583
shiphelp@hapnetwork.org