MedicaidCoverageMedium impact
Retroactive Eligibility Determination and Medicare Part D Excluded Drug Coverage
Maryland Medicaid·MD · Pharmacy·Pharmacy
Effective date
Jan 1, 2006
We identified it
Jun 20, 2026
Summary
Maryland Medicaid will continue covering Medicare Part D excluded drugs (barbiturates, benzodiazepines, legend vitamins, and legend cough/cold preparations) for dual-eligible recipients. For retroactively eligible Medicaid recipients, coverage for these excluded drugs will only apply from their Medicaid eligibility start date forward.
Action Required
Billing team should verify dual eligibility status before billing Maryland Medicaid for barbiturates, benzodiazepines, legend vitamins, and legend cough/cold preparations. For retroactively eligible patients, only bill Medicaid for these excluded drugs from their eligibility start date forward. Contact Division of Pharmacy Services at 410-767-1455 with questions.