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does Medicare cover over the counter drugs

Does Medicare Cover Over The Counter Drugs?

Over-the-counter medications or, OTC drugs for short, are medications you do not need a doctor’s prescription for. You can easily purchase them at any pharmacy or even convenience store.  

One of the most common types of OTC drugs people take are for pain relief. Think of Advil, Excedrin or Tylenol. Allergy meds are another very common type of OTC drug.  

Other common types of OTC drugs treat things such as diarrhea, sore throat, nausea and coughing. 

People in the US spend billions on these drugs each year. So a common question many people have is, “Does Medicare cover Over The Counter Drugs?” In this article, we answer the question in clear, plain English.  

Does Medicare Cover Over The Counter Drugs? 

The short answer is no. In most cases, Medicare will not cover the cost of your OTC medications. That said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your OTC drugs.  

Original Medicare (Medicare Part A and Part B) does not provide coverage for OTC drugs. Original Medicare does not cover OTC medications such as: 

  • Vitamins and minerals (except some few including prenatal vitamins and fluoride preparations) 
  • Medications for treating cold or cold symptoms 
  • Drugs used for weight loss or weight gain 
  • Drugs used for cosmetic purposes 

However, Original Medicare may provide coverage for prescription medications that fall in the same categories as the ones above. But Original Medicare may only cover those types of prescription medications if your doctor orders them to treat a specific medical condition.  

Part C Coverage 

If you have a Medicare Advantage plan (Medicare Part C), you may be in luck here. Some Part C plans will provide coverage for over-the-counter medications.  

Medicare Advantage plans must cover everything Original Medicare covers. But many also offer some additional benefits. Exactly what they cover and what the out-of-pocket costs are will vary depending on the specifics of your plan.  

The Center of Medicare and Medicaid Services (CMS) does allow Medicare Part C plan carriers to provide coverage for over-the-counter medications. They allow it for these reasons: 

  • Improve preventive care 
  • Reduce health care complications 
  • Help in making health costs less expensive 

Some Medicare Part C plans that provide coverage for OTC medications partner with national retail pharmacies such as CVS or Walmart. Plan members with those benefits can go to those stores to get their OTC drugs.  

There are even some Medicare Part C plans offer home delivery of OTC medicines. Be sure to check with your plan to see if that option is available.  

Medicare Part D Coverage for Over The Counter Drugs 

Medicare Part D also does not provide coverage for over-the-counter medications. 

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover a colonoscopy?

 

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