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Table of Contents
Getting Started - The Basics
About Enrolling
Costs and Coverage
Problems Getting Your Drugs Under Your Plan
Other Common Problems / Changing Plans
Information for Medicare Providers
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What if my drug is not covered by 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;
- Barbituates; and
- Benzodiazapines.
- Drugs used for treatment of sexual or erectile dysfunction (ED). However, ED drugs are 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 Part D, you may be able to purchase an enhanced Supplemental Medicare
Prescription Drug Plan that offers coverage for some excluded
drugs.
Call 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 1-877-774-7772
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