Are there any exclusions from my Part D Prescription Drug Coverage?

By law, certain types of drugs or categories of drugs are not covered under Medicare Part D. In those cases, Medicare exempts the drugs or drug categories from the exception and appeals processes. These drugs or categories are called "exclusions.” They include:

  • Prescription vitamins and mineral products with the exception of prenatal vitamins and fluoride preparations
  • Agents when used for anorexia, weight loss, or weight gain
  • Drugs used to promote fertility
  • Agents when used for cosmetic purposes or hair growth
  • Drugs for erectile dysfunction
  • Barbiturate and benzodiazepine medications*
  • Agents used to treat the symptoms of coughs or colds

*As an enhanced benefit, BlueCHiP for Medicare Standard with Drugs (HMO), BlueCHiP for Medicare Plus (HMO) and BlueCHiP for Medicare Preferred (HMO-POS) plans offer additional coverage on generic benzodiazepine and generic barbiturate medications not normally covered in a Medicare Prescription Drug Plan. If you receive extra help paying for your drugs, you will NOT receive Extra Help paying for these particular drugs. The applicable non-LIS tier copayment will apply for these drugs. These generic medications are covered throughout the plan year. As non-Medicare covered medications, these drugs do not count toward your true-out-of-pocket costs or toward catastrophic coverage.

Last updated: 04/18/2012

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Blue Cross & Blue Shield of Rhode Island is an HMO plan with a Medicare contract. Enrollment in Blue Cross & Blue Shield of Rhode Island depends on contract renewal.