There are certain types of drugs that are excluded from Medicare coverage by law.
Medicare does not cover:1
- Drugs used to treat anorexia, weight loss, or weight gain.
- Note: Part D may cover drugs used to treat physical wasting caused by AIDS, cancer, or other diseases
- Fertility drugs
- Drugs used for cosmetic purposes or hair growth
- Note: Drugs used for the treatment of psoriasis, acne, rosacea, or vitiligo are not considered cosmetic drugs and may be covered under Part D
- Drugs that are only for the relief of cold or cough symptoms
- Drugs used to treat erectile dysfunction
- Prescription vitamins and minerals (except prenatal vitamins and fluoride preparations)
- Non-prescription drugs (over the counter drugs)
Note: Prescription drugs used for the above conditions may be covered if they are being prescribed to treat other conditions. For example, a medicine for the relief of cold symptoms may be covered by Part D if prescribed to treat something other than a cold—such as shortness of breath from severe asthma—as long as it is approved by the U.S. Food and Drug Administration (FDA) for such treatment. 1
Keep in mind just because Medicare does not exclude your prescription drugs, you still need to make sure that your drugs are in the *formulary for your plan or it will not be covered by your plan, with very few exceptions.
*Formulary is a list of drugs covered by your plan.
1. Source: https://www.medicareinteractive.org/get-answers/medicare-prescription-drug-coverage-part-d/medicare-part-d-coverage/drugs-excluded-from-part-d-coverage
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