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What does Part D cover?

Part D covers a wide range of prescription drugs — but not everything. Here's what's included and what's not.

What Part D covers

  • Generic prescription drugs
  • Brand-name prescription drugs
  • Insulin — capped at $35/month for covered products
  • Vaccines — recommended by the Advisory Committee on Immunization Practices (ACIP), including shingles, RSV, Tdap, and others at $0 cost
  • Specialty medications — high-cost drugs for complex conditions
  • Biological products and biosimilars

What Part D does NOT cover

  • Over-the-counter (OTC) medications
  • Drugs for cosmetic purposes
  • Drugs for weight loss or weight gain
  • Drugs for erectile dysfunction
  • Drugs for fertility
  • Drugs covered under Medicare Part B (typically administered by a doctor — like chemotherapy infusions or certain injections)
  • Drugs not approved by the FDA

Part B vs. Part D drugs

Some drugs are covered under Part B rather than Part D — typically medications administered by a healthcare provider (injections, infusions, nebulizer drugs). If you're unsure which part covers your medication, check with your plan or ask your doctor.

Each plan covers different drugs

While Medicare requires all Part D plans to cover drugs in every therapeutic category, the specific drugs each plan covers vary. That's why checking a plan's formulary before enrolling is essential.

Learn how formularies and drug tiers work →