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Which drugs do all plans exclude by law?

The law says the plans do not have to cover some drugs:

  • Over-the-counter drugs that you can buy without a prescription
  • Drugs used for the symptoms of cough and colds
  • Prescription vitamins and minerals, except for prenatal vitamins and fluoride preparations
  • Barbiturates, unless if (starting in 2013) used to treat epilespy, cancer, or a chronic mental disorder. These drugs are typically used for sedation or to control seizures. Example: Phenobarbital or Nembutal®
  • Drugs used for anorexia, weight loss or weight gain
  • Drugs used to promote fertility
  • Drugs to increase hair growth

Plans with Enhanced Alternative Drug Coverage

Plans can have “enhanced alternative coverage.” This means they can cover some of these excluded drugs. They would probably charge a higher premium for this additional benefit.

NEXT: Will the plan cover the injectable drugs – or shots – I get in my doctor’s office?

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