Drugs Not Covered Under Medicare Part D
Our prescription savings card may help you even if you are covered under a Medicare Part D plan because hundreds of prescription medicines are either not covered by Medicare or are not covered by the specific Medicare plan offered by your insurer.
All Medicare prescription drug plan insurers are required to publish a list of prescription medicines they cover. You should always check a plan’s formulary to be sure your medicines are covered before you enroll in the insurer’s plan. Many medicines are not covered at all by any Medicare plan and many others are just not covered by the plan being offered by insurers. Once you are enrolled an insurer is restricted from changing their formulary from the beginning of the plan’s annual election period until 60 days after the plan coverage begins unless the FDA determines a drug is not safe or the drug is no longer available in the marketplace. Insurer’s must notify plan members of any formulary changes and must state the reason for the changes. Always make sure your prescription medicines are in their formulary before you enroll and have not been removed from the formulary before you re-enroll.
All Medicare drug plans are required to cover all commercially available “vaccine” drugs deemed necessary to prevent illness. The insurer otherwise can decide which drugs to cover or not to cover and which pricing tier they are covered under.
Medicare Part D plans usually do not cover any of the following:
• Weight loss or weight gain drugs
• Prescriptions for cosmetic purposes or to enhance hair growth
• Fertility medications
• Drugs for sexual or erectile dysfunction, like Viagra or Cialis
• Nonprescription medicines
• Barbiturates
• Medicines covered under Medicare Part A or Part B.
This list does not cover all categories of medicines not covered by Medicare Part D or all exceptions to coverage. You should consult both medicare.gov and your plan’s insurer to be sure your medicines are covered before you enroll.
