The following drugs or their medical uses are excluded by law from Medicare Part D coverage.
- Drugs for anorexia, weight loss or weight gain
- Drugs to promote fertility
- Drugs for cosmetic purposes or hair growth
- Prescription vitamins and mineral products, except for prenatal vitamins, fluoride preparations, vitamin D analogs (calcitriol, doxercalciferol, paricalcitol) and prescription niacin products
- Nonprescription (over-the-counter) drugs
- Outpatient drugs for which the manufacturer requires associated tests or monitoring services to be purchased exclusively from the manufacturer or its designee as a condition of sale
- Drugs used for the treatment of sexual or erectile dysfunction, unless they are used to treat a condition other than sexual or erectile dysfunction that is approved by the FDA such as pulmonary hypertension
- Drugs for symptomatic relief of cough and/or colds, except when used to treat the underlying medical conditions that cause the cough (e.g. cough from bronchospasm in asthma)
CMS Medicare Prescription Drug Benefit Manual, Chapter 6, Feb. 19, 2010. Revision 18, 01-15-16
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform. |