What if my drug is not covered by Medicare Part D?
You may need to pay out-of-pocket for drugs specifically excluded from Medicare Part D coverage, which include the following:
- Over-the-counter drugs, with the exception of insulin;
- Drugs when used for anorexia, weight-loss or weight-gain;
- Drugs to relieve cough/cold symptoms;
- Drugs to promote hair growth;
- Fertility drugs;
- Prescription vitamins and mineral products, 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;
- Drugs used for treatment of sexual or erectile dysfunction (ED). However, ED drugs are Medicare Part D drugs if used for medically accepted indications approved by the FDA other than sexual or erectile dysfunction (such as pulmonary hypertension).
If your drugs are excluded by Medicare Part D, you may be able to purchase an enhanced Supplemental Medicare Prescription Drug Plan that offers coverage for some excluded drugs.
Call your local Area Agency on Aging, the Maine State Health Insurance Assistance Program (SHIP) at 1-877-353-3771, or TTY: 1-800-750-5353 for more information.
|NOTE: If you have Maine Care, or the Drugs for the Elderly (DEL) program, drugs on the above list may be covered by that program. Be sure your pharmacist knows you have MaineCare or DEL.|
For questions or advice,
contact the Medicare Part D Appeals Unit of
Legal Services for the Elderly at