| Drugs when used for anorexia, weight loss, weight gain |
None |
| Drugs when used to promote fertility |
None |
| Drugs when used for cosmetic purposes or hair growth |
None |
| Drugs when used for the symptomatic relief of cough and colds |
Antihistamines, Decongestants, Antihistamine/Decongestant Combination Products; Some OTC Antitussive and/or Expectorants; some Legend Antitussive and/or Expectorants. |
| Prescription vitamins and mineral products |
Prenatal Vitamins for women up through age 45; Vitamin K, Cyanocobalamin; Niacin; Vitamin D; Folic Acid as a single entity; Fluorinated Pediatric Vitamins (for beneficiaries under age 21); Some Renal Vitamins (for dialysis patients). |
| Nonprescription drugs (Over-the-Counter) |
Insulin; Allergy and Sinus Products; Analgesics/Antipyretics; Digestive Medications; Topical Products; Oral Electrolyte Replacement
Mixtures; Vitamins and Minerals listed on the covered OTC Formulary; Ophthalmic Lubricants. |
| Barbiturates |
Limited to Phenobarbital and Mephobarbital |
| Benzodiazepines |
Limited to Generic Formulations |
| Smoking Cessation |
Food and Drug Administration (FDA) approved smoking cessation and nicotine replacement products |