What Medicare Part D covers
With so many drugs designed to treat an infinite number of conditions on the market, many beneficiaries wonder which drugs are covered by Part D. All plans have approved lists of medications and the government mandates that any plan must have at least two drugs in each therapeutic class. They are also required to cover a majority of drugs in six particular categories: antidepressants, antipsychotics, anticonvulsants, immunosuppressants, anti-cancer medications, and HIV/AIDS drugs. Plans are also obligated to cover most vaccines that aren’t covered by Part B.
While carriers are compelled to provide a number of options to beneficiaries for most conditions, there are medications the plans are forbidden to cover by law. Those include, but are not limited to:
- Drugs used for or to treat weight loss or gain, erectile dysfunction, fertility, and cosmetic purposes
- Vitamins
- Non-prescription drugs
- Off-label use drugs
- Medical foods that are not regulated as drugs
- Drugs covered under Part A or B (i.e. chemotherapy medications, certain vaccines, immunosuppressive drugs given after an organ transplant, etc.)
