Covered Drugs

Medicare Part D plans generally include all drug costs covered by Medicaid and exclude all drugs for which payment is made available under Medicare Part A and Medicare Part B.

By law, Part D drugs must be:

  • Available only by prescription
  • Approved by the FDA
  • Sold and used in the United States
  • Used for a medically-accepted condition

Important facts:

  • All Medicare Part D plans are required to include at least 2 medications from each therapeutic category.
  • Different Part D plans cover different drugs, depending upon approved Formulary.
Drug CoverageCovered Not Covered
Alcohol Swabs ✓
Anorexia x
Barbiturates ✓
Benzodiazepines ✓
Biological Products ✓
Cosmetics x
Erectile Dysfunctions (ED) x
Fertility x
Gauze ✓
Insulin ✓
Necessary Syringes ✓
Needles ✓
OTC Meds x
Prescriptions ✓
Prescription Vitamins x
Vaccines ✓
Weight Gain x
Weight Loss x

Drugs are covered by TEAMStar Medicare Part D Prescription Drug Program (PDP) if it's a Formulary drug filled at a network pharmacy or through our mail order pharmacy service. In certain situations, prescriptions filled at an out-of-network pharmacy may also be covered. Check the Evidence of Coverage Chapter 3, Section 2.6 for those situations.

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Formulary.aspx

Drug Lookup and Pricing

Search for drugs covered on our Formulary and find out your costs.