Not necessarily.
Certain types of drugs are not covered by Part D (the"excluded" drugs),
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; and
- Benzodiazapines.
- Beginning in 2007, drugs used to treat erectile dysfunction are excluded from Part
D. These drugs may be covered by Part D if used to treat other conditions, such as
pulmonary hypertension.
| NOTE:
If you are a member of MaineCare or the Drugs for the Elderly
program (DEL), those programs may pay for some of the drugs listed above.
Be sure your pharmacist knows you are in MaineCare or DEL.
|
In addition, some drugs are covered by Medicare Part B and are therefore not
covered by part D. In that case, your pharmacist should bill Medicare Part P.
Even if your drugs are not "excluded" drug or Part B 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."
If your drug is on your Part D Plan’s formulary, the Plan may have restrictions
on it, such as quantity limits, "step therapy" requirements. or a requirement
that your doctor obtain Prior Authorization.
To find out about which Part D plan's formulary will best meet your prescription
needs, go to the Medicare website
Formulary
Finder on the web,
OR
Call the Maine State Health Insurance Assistance Program (SHIP) at
1-877-353-3771, or TTY: 1-800-750-5353.
| 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 |
