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Additional Notes on the Medicare Part D Formulary

As noted, a Medicare Part D plan's Formulary is another name for the plan's prescription drug list or guide.

:: Which Prescription Drugs are Excluded from Medicare Part D?
:: Can a Medicare Part D Plan's formulary change?
:: Are In- or Out-patient Medications covered under Part D?

Which Prescription Drugs are Excluded from Medicare Part D?

A certain group of medications are specifically excluded from Medicare Part D plans and they include:
  • Certain anti-anxiety and anti-seizure drugs - Barbiturates (Barbiturates include: Pentobarbital (Nembutal), Secobarbital (Seconal), Amobarbital (Amytal) and Phenobarbital (Luminal).) and Benzodiazepines (Benzodiazepines include: Xanax, Klonopin, Valium, Ativan, etc.)
  • Most prescription vitamins and minerals (with the exception of prenatal vitamins and fluoride preparations)
  • Prescription drugs used for - anorexia, weight loss or weight gain; fertility; cosmetic purposes or hair growth; relief of symptoms of colds


:: Read more about Prescription Niacin Coverage

:: Top

Can a Medicare Part D Plan's formulary change?

Yes - A Medicare Part D plan's list of covered prescription drug or Formulary can change with 60 days prior notice to the Medicare Part D plan's participants or members. Each Medicare Part D plans provides information about how you will be notified in the event of a formulary change.
Please note CMS passed recent guidance that protects current plan members from changes to the plan's formulary or drug list! See the link below:


:: Read more about Formulary Changes and your Rights

:: Top

Are In- or Out-patient Medications covered under Part D?

No - Medicare Part A is covering your inpatient medications (for hospital or skilled nursing stays. Medicare Part B will cover your outpatient medications.


:: Read more on Medicare A and B coverage
:: Top


Last updated on: 11/14/2008

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