Original Medicare doesn’t include coverage for most prescription drugs. That being stated, adding a stand-alone prescription drug plan, also known as Medicare Part D, can help you pay for your prescriptions and may protect you from high drug costs. Besides prescription drugs, vitamins and other supplements are an essential part of many peoples’ healthcare routine but Medicare usually doesn’t cover them.
Insurance carriers can bundle vitamin supplementation coverage together with their Part D plan. There are some other exceptions as well that are worth mentioning, so keep reading to get to know everything about vitamin and Part D coverage.
What Does Medicare Part D Cover Exactly?
Most Medicare drug plans have their own list of what drugs are covered. In general, these are the types of drugs Medicare Part D covers:
- HIV/AIDS treatments
- Antidepressants
- Antipsychotic medications
- Anticonvulsive treatments for seizure disorders
- Immunosuppressant drugs
- Anticancer drugs (unless covered by Part B)
Part D plans must also cover most vaccines, except for vaccines covered by Part B.
When Is It Possible To Get Coverage For Vitamins?
Usually, it is only possible to get vitamin coverage as part of Medicare Part B and Part D in case of a health diagnosis or a recommendation by a healthcare worker. When deciding whether one qualifies for Medicare vitamin coverage, the most important things to consider are an individual’s health status and specific insurance plan.
There are some Medicare Part D Plans that include what is called “enhanced alternative coverage” in their benefits which means that those plans contain items that surpass the standard Medicare Part D coverage. Plans with enhanced alternative coverage might cover some vitamins and supplements.
To conclude, vitamin and supplement coverage that is not recommended by a doctor probably won’t be covered by Medicare (multivitamins included). If it turns out you have a diagnosis of a disease that requires treatment backed by vitamins and supplements you might be eligible for coverage under Medicare but you will need to have evidence for that.
What other drugs does Medicare Part D not cover?
There are certain kinds of drugs that are excluded from Medicare coverage by law. Those are:
- Drugs used to treat anorexia, weight loss, or weight gain
- Fertility drugs
- Drugs used for cosmetic purposes or hair growth
- Note: Drugs used for the treatment of psoriasis, acne, rosacea, or vitiligo are not considered cosmetic drugs and may be covered under Part D
- Drugs that are only for the relief of cold or cough symptoms
- Drugs used to treat erectile dysfunction
- Prescription vitamins and minerals (except prenatal vitamins and fluoride preparations)
- Non-prescription drugs
It is important to notice that Part D may cover drugs used to treat physical wasting caused by AIDS, cancer, or other diseases. Also, some drugs that are prescribed for conditions mentioned in this list, may be covered if they are somehow correlated to another condition that needs treatment. For more information, make sure to read our blog What other drugs does Medicare Part D not cover?
Conclusion
In conclusion, besides drugs that are covered by the law, it depends on your diagnosis and specific needs if other drugs, supplements, and vitamins, that are not on the list, will be covered for you. It would be best if you took the time to contact a Medicare advisor to get help with your situation and ask if any of the supplements you might need could be covered. Other than with a Medicare advisor, make sure you get in touch with a healthcare worker of your choice who will give you a thorough report of your health status and give you a list of drugs and supplements that are important for whatever condition you have. The diagnosis you get is the only thing that potentially qualifies you for supplements that are usually not covered by Medicare Part D.
Craig W. Hansen is an insurance professional and co-founder of William & Michael Advisor Group LLC and Jersey Insurance Solutions. Craig has served his clients in many facets of the insurance industry, always with the same goal: excellence in service while building solid, long-term, lasting relationships. With over a decade of experience in the insurance benefits industry, Craig’s clients know they can call on him anytime and receive platinum service with a smile.
