Guide to Medicare Part D: Will Part D Pay For All Of My Prescriptions?
This page is part of our Guide to Medicare Part D.Not necessarily.
Each plan covers only the drugs that are included on its "formulary," which means its list of covered drugs.
In addition, certain types of drugs are not covered by Part D, including:
- Over-the-counter drugs, with the exception of insulin
- Weight-loss and weight-gain drugs
- Drugs to relieve cough/cold symptoms
- Drugs to promote hair growth
- Fertility drugs
- Prescription vitamins, with the exception of prenatal vitamins and fluoride;
- Cosmetic drugs
- Drugs that must be monitored by testing services that only the manufacturer provides, such as certain anti-psychotics
- Barbituates
- Benzodiazapines
Even if your drugs do not fall into one of the above categories of excluded drugs, your prescriptions may not be covered by your particular Part D plan. This is because each Part D plan has a unique list of drugs it will cover. A Part D plan's drug list is known as a "formulary."
The best way to determine what drugs are covered by what plans is to use the personalized plan search on the Medicare website.
| NOTE: If you cannot find a plan that covers all of your drugs, you may be able to enroll in a plan and request an "Exception" to obtain full coverage. For more information, see our exceptions page |
Reviewed August 2009
This online guide was adapted with permission from Maine Legal Services for the Elderly. We extend our thanks to them.