click to call image

Drugs never covered by Medicare

There are many drugs that no Medicare Part D plans will cover, based on national Medicare guidelines.

  • Drugs for anorexia, weight loss, or weight gain (i.e., Xenical, Meridia, phentermine HCl, etc.)
  • Drugs that promote fertility (i.e., Clomid, Gonal-f, Ovidrel, Follistim, etc.)
  • Drugs for cosmetic purposes or hair growth (i.e., Propecia, Renova, Vaniqa, etc.)
  • Drugs for the relief of cough and cold symptoms (i.e., Phenergan w/Codeine, Robitussin AC, Tanafed, Tessalon Perle, etc.)
  • Prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations (i.e., Nephrocaps, Foltx, Cyanocobalamin, etc.).
  • Nonprescription drugs
  • Drugs for sexual dysfunction (i.e., Viagra, Cialis, Levitra, Muse, Caverject)
  • Non-FDA-Approved products
  • DESI drugs (see explanation of DESI drugs, below)
  • Bulk chemicals in the following STCs: U6I, U6Q, U6U, U6W, and U6X
    Bulk chemicals do not meet the definition of a Part D-covered drug (FDA-approved, prescription medication with a compendial indication)
  • Devices (i.e., diaphragms)
  • Ingredient/adjuvant (i.e., sterile water for injection)
  • Line flush (i.e., normal saline IV flush, Heparin Sodium Lock Flush)
  • Medical supplies (i.e., Biafine, ethyl alcohol)
  • Drugs covered under Part A or Part B (i.e., Xeloda, Temodar, Advate)

DESI drugs

A DESI (drug efficacy study implementation) drug is one that the FDA has determined to be safe, but not effective. Here are some examples of DESI drugs that are not covered by any Medicare Part D plan:

  • Alcortin gel
  • Amidrine capsule
  • Analpram HC 2.5% cream
  • APAP-Isomethep-Dichlphen cap
  • Belladonna/Phenobarb tablet
  • Bellaspas tablet
  • Clidinium/CDP capsule
  • Duradrin capsule
  • EEMT HS tablet
  • Epidrin capsule
  • Essian tablet
  • Estratest H.S. tablet
  • Estrogen-Methyltestost H.S. tab
  • HC Pramoxine 2.5% cream
  • HC Pramoxine 2.5% rectal cream
  • Hemorrhoidal HC 25mg supp
  • Hydrocortisone AC 25mg supp
  • Isometh/D-Chloralphenz/APAP
  • Isoxsuprine 10mg tablet
  • Migquin capsule
  • Migratine capsule
  • Migrin-A capsule
  • Pramosone 1% cream
  • Proctosert HC 30mg supp
  • Rectasol-HC 25mg supp
  • Syntest D.S. tablet
  • Tebamide 200mg supp
  • Trimethobenzamide 200mg supp