What Are Medicare-Approved Drugs?


Quick Answer

Medicare-approved drugs are prescription medications covered by the Medicare Prescription Drug Plans. Also known as Medicare Part D, the government medical program publishes a formulary that includes the drugs covered under its umbrella, as explained by the Group Health Cooperative.

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Full Answer

The formulary includes five different levels of classification for approved prescription medicines. Drugs in lower tiers cost the patient less than those listed in higher brackets. If a pharmacist or physician decides that a patient needs a drug listed in a higher bracket than ones listed in the lower price range, the patient can file an exception with the plan, as reported by Medicare.gov.

The Pharmacy and Therapeutics Committee reviews available drugs and breaks them down into different cost levels based on safety, effectiveness and value. Medical experts from a wide range of specialties form the committee, according to Group Health.

Certain drugs listed on the official formulary are only available under Medicare for specific plans agreed upon by the individual. Excluded drugs from Medicare coverage, by law, include prescription vitamins and minerals, and medications used for anorexia, weight loss, weight gain, hair growth and cosmetics. Other exclusions in a plan’s coverage are fertility and erectile dysfunction drugs, according to MedicareInteractive.org.

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