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Long-Term Care Survey Alert

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Know What's Covered And Not Under Part D

Some drugs are covered by Part D and Part B.

Drug Formularies Under Part D

What is covered?
• Prescription drugs only
•&²Ô²ú²õ±è;¹ó¶Ù´¡-²¹±è±è°ù´Ç±¹±ð»å
• Medically approved indication
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 - Supplies required for administration
•&²Ô²ú²õ±è;µþ¾±´Ç±ô´Ç²µ¾±³¦²¹±ô²õ

Note: Some 600 drugs can be covered by Part D or Part B. Part B is always the primary coverage in such cases.

Formulary Exclusions

• OTC Drugs
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•&²Ô²ú²õ±è;µþ±ð²Ô³ú´Ç»å¾±²¹³ú±ð±è¾±²Ô±ð²õ
• Cough--cold remedies
• Products for weight management
•&²Ô²ú²õ±è;³Õ¾±³Ù²¹³¾¾±²Ô²õ
 - Prenatal exception
•&²Ô²ú²õ±è;±õ²ÔÂá±ð³¦³Ù²¹²ú±ô±ð²õ
• Infusion products
• Drugs & Biologicals paid by Medicare A and B

Source: David Jones, RPh, FASCP

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