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.
