Part D Enhanced Drug Coverage

A part of Original Medicare known as Medicare Part D helps cover the cost of most prescription drugs, and SCAN Medicare Advantage plans include Part D coverage for a wide range of prescription drugs that people with Medicare take.

There are certain drugs and prescription vitamins that may be medically necessary but aren’t covered by Medicare Part D, which means you must pay for them yourself. That’s why SCAN added Part D Enhanced Coverage—to help you get the medication you need at a cost you can afford.

Three different prescription vitamins are covered on Tier 1 of SCAN’s formulary (list of covered drugs) through SCAN’s Enhanced Drug Coverage benefit:

  • Cyanocobalamin (Vitamin B12) 1,000mg vial
  • Ergocalciferol (Vitamin D2) 1.25mcg capsules
  • Folic Acid (Vitamin B9) 1mg tablets
Generic Viagra (sildenafil) used for erectile dysfunction (ED) is also covered on Tier 1 through SCAN’s enhanced drug coverage benefit. It’s available in the following strengths: 25mg, 50mg, and 100mg with the following limits:

  • 4 tablets per 30 days
  • 12 tablets per 90 days
  • Yearly maximum of 49 tablets
NOTE: If you require more than 49 tablets per year, you’ll need to pay out of pocket for the extra tablets.

To see if your SCAN plan covers these prescription drugs, check your Evidence of Coverage or use SCAN’s formulary drug search.

Part D Excluded Drugs

While SCAN tries to make the medicine you need available at a cost you can afford, there are certain categories of drugs that are excluded from Medicare Part D coverage by law. That means they aren’t covered by Medicare or your SCAN plan. You would need to pay out-of-pocket for these medications.

These drug categories are not covered as part of your prescription drug benefit:

1. Drugs when used for anorexia, weight loss, or weight gain even if used for a non-cosmetic purpose like morbid obesity.
2. Drugs when used to promote fertility.
3. Drugs when used for cosmetic purposes or to promote hair growth.
4. Drugs when used for the relief of cough and cold symptoms.
5. Prescription vitamins and mineral products, except for prenatal vitamins and fluoride preparations.
6. Non-prescription drugs (also called over-the-counter drugs).
7. Drugs when used for the treatment of sexual or erectile dysfunction.

Find pharmacy coupons to help pay for excluded Part D drugs and savings for your medication using the SCAN Rx Savings Finder Tool or visit Patient Assistance Programs for the Coverage Gap to learn more.


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