What Are Drugs That Are Covered by Medicare?


Quick Answer

As of 2015, the drug lists for each Medicare Prescription Drug Plan must include a minimum of two drugs per approved drug category to ensure that patients have access to the medically necessary drugs they need, according to Medicare.gov. The list of prescriptions is different for each plan offered.

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What Are Drugs That Are Covered by Medicare?
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Full Answer

All Medicare prescription plans are required to cover nearly all drugs within certain protected classes, such as HIV/AIDS. Other drug categories with mandated coverage include antidepressants, cancer drugs, immunosuppressants, antipsychotics and anticonvulsants, notes Medicare.gov.

Drug categories that are not typically covered by Medicare include erectile dysfunction, weight gain and weight loss, explains Medicare.gov. However, some plans may offer such drugs as an additional benefit. Over-the-counter drugs are generally not covered by Medicare, although Medicaid may cover them in some states.

Prescription drugs that are covered may require the patient to make a copayment that varies based on the plan, instructs Medicare.gov. Unless a patient has a formulary exception with Medicare, full price is required for all prescription drugs not covered under the plan.

Changes to the approved list of drugs for each Medicare prescription drug plan are allowed, advises Medicare.gov. Before a drug is removed from the list, a 60-day written notice is mailed to impacted patients ahead of the change. Alternatively, if a patient requests a refill, a 60-day supply of the drug is provided along with a copy of the notice of change.

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