Drugs Medicare does not cover

Drugs not covered by Medicare Part D plans

There are many drugs that no Medicare Part D plans, including those from PriorityMedicare^SM, cover, based on national Medicare guidelines.

Jump down this page to find:

• What types of drugs doesn't Medicare cover?
  
• Recent changes/additions to the list of drugs Medicare does not cover
• DESI drugs (determined by the FDA to be safe, but not effective)

Types of drugs Medicare does not cover

• 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 other than Prilosec OTC and loratadine products
• Barbiturates (i.e., Phenobarbital, Seconal Sodium, Butisol Sodium, etc.)
• Benzodiazepines (i.e., clorazepate dipotassium, Ativan (lorazepam), Valium (diazepam), Xanax (alprazolam), Librium (chlordiazepoxide HCl), Serax (oxazepam), etc.)
• 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)

Updates to Medicare's non-covered drug list in 2008:

DESI drugs

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

• 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