“If you have never filled a topical NSAID, an OTC allergy eye drop, an OTC nasal spray, or an ivermectin lice treatment through Part D, this will not touch your budget.
If any of those show up on your pharmacy printout with a plan-paid amount next to them, you are in the affected group, and the change is coming on a timeline nobody has announced.
The trap is that it looks like a formulary problem, and open enrollment reflexes tell people to shop for a plan that covers the drug. No Part D plan can cover it as a Part D drug, because every plan is bound by the same statutory exclusion. Shopping formularies does not solve this one. Some Medicare Advantage plans do offer separate OTC allowances or similar non-Part-D assistance, which is a different benefit worth asking about rather than a workaround.”