Medicare Part D Prescription Drug Plans (Part D) cover outpatient prescription drugs. Each Part D plan has its own formulary, which is a list of drugs that a plan covers.
The law requires all Part D plan formularies to include at least two drugs in most categories—or classes—of drugs, and substantially all drugs in the following six classes:
- Immunosuppressants, which are used to prevent an individual’s body from rejecting an organ after a transplant
- Antidepressants, which are used to treat depression
- Antipsychotics, which are used for schizophrenia and bipolar disorder
- Anticonvulsants, which are used to treat epileptic seizures
- Antiretrovirals, which are used to treat HIV and AIDS
- Antineoplastics, which are used to prevent the development of tumors
Some drugs are excluded from Medicare coverage by law and cannot be covered by any Part D plan. These include:
- Drugs used to treat anorexia, weight loss, or weight gain; however, 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
- Drugs that are only used to treat cough or cold symptoms
- Drugs used to treat erectile dysfunction
- Drugs that have not been approved by the Food and Drug Administration (FDA)
- Prescription vitamins and minerals, except for prenatal vitamins and fluoride preparations
- Most over-the-counter drugs, like Tylenol® and Advil®
Read Next: Are Vaccines Covered by Part D Prescription Drug Plans?
Find Out: What Are the Part D Prescription Drug Plan Costs?
Return to: Medicare Part D
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