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Six Protected Classes Under Medicare Part D


The Six Protected Classes is a policy put forth by joint efforts of The Centers for Medicare and Medicaid Services (CMS) and the United States Congress. This policy gives Part D recipients access to prescriptions for serious health complications.

The Six Protected Classes – What’s Covered?

There are six protected classes associated with Part D. Also, these protected classes ensure that seniors and individuals living with specific disabilities can obtain the medication they need.

The six protected types of drugs consist of:

  1. Immunosuppressants
  2. Antiretrovirals
  3. Antidepressants
  4. Antineoplastics
  5. Anticonvulsants
  6. Antipsychotics

By assuring access to these prescriptions, patients are in a better position to continue their current treatment for the diseases they battle, such as:

  • Mental illness
  • Cancer
  • HIV/AIDS
  • Epilepsy
  • Patients experiencing organ transplantation

No matter the costs of medications within these classifications, the six protected classes policy ensures that patients can continue the medications the doctor orders.

Also, patients that have access to medications are more likely to have a healthier life and perhaps even longer lives.

Epilepsy and Part D

Recent studies show epilepsy to be the most popular brain disorder in the entire world. Further, this brain disorder can cause seizures.

This disorder knows no-bounds as far as location, age, race, or social class goes.

Roughly 3.4 million residents within the United States live with epilepsy. Strokes, brain tumors, and severe head trauma are just a few causes of epilepsy among patients.

Further, Anticonvulsants are drugs that aid in the control of epilepsy; those types of medications are one of the six protected classes.

Mental Health and Prescriptions

Mental health illness is a term that extends to a wide variety of mental health conditions. Also, these conditions can impact individuals’ moods, behaviors, and thoughts.

A mental illness diagnosis comes from a doctor; when patients face continuous symptoms, these symptoms begin to have an overall effect on daily life.

Several examples of mental illness can include:

  • Depression
  • Addiction
  • Anxiety
  • Schizophrenia

Further, medications can assist people with mental health disorders; bringing ease and relief of stress to many people. Both antipsychotics and antidepressants are treatments for mental illnesses; both drug types are part of the six protected classes.

Chemotherapy Drugs for Cancer

Cancer is the formation and rapid growth of cells that are abnormal in a person’s body. Also, these abnormal cells destroy the body’s tissue.

There are many forms of cancer, some of the most common being:

  • Lung cancer
  • Prostate cancer
  • Breast cancer
  • Skin cancer
  • Kidney cancer
  • Chemotherapy

HIV and AIDS

HIV medications are antiretrovirals. Further, HIV (Human Immunodeficiency Virus) attacks immune systems by going after the body’s white blood cells.

The white blood cells are the cells that must fight infections within the body. Also, with the attack on the human body, people are at higher risk for diseases and cancers.

AIDS is the last stage of infection with HIV, the medications necessary are part of the six protected classes.

Organ Transplantation

Immunosuppressants are prescription medications used for individuals who have undergone organ transplants. Organ transplants are for patients who experience organ failure.

The process of transplantation is when doctors remove a failing organ and replace it with a thriving organ from a donor. The donor could be from a living donor or a donor who has passed away.

Transplant organs may include:

  • Heart
  • Kidney
  • Lung
  • Pancreas
  • Liver

Wait times for organ transplants are typically very lengthy, and operations carry the risk of rejection once placed in the patient’s body. Prescription Immunosuppressants will be needed for the remainder of a patient’s life to minimize the risk of organ rejection.

As you can see, the Six-Protected Classes are incredibly essential factors in the health care world. These medications can make a difference in a patient’s quality of life.

Whether a patient has cancer, HIV, mental illness, epilepsy, or has received an organ transplant, these medications can be critical for an individual’s well-being.

The six protected classes offer patients peace of mind who live with severe, debilitating, and complex conditions. Peace of mind that they may have access to medications in the most crucial of times.

This effort put forth by CMS and the United States has made it so patients may live higher-quality lives both health-wise and emotionally.

By providing access to crucial medications, patients may begin to thrive and may even live a longer life.

How to Get Help With The Six Protected Classes Under Part D

If you or a loved one has any questions regarding Part D or the six protected classes, please feel free to give us a call today at the number above.

Not only can our team assist in choosing Medicare coverage for you, but we can also offer guidance throughout any course of your Medicare expedition.

Feel free to complete an online rate form, and a member of our team will reach out to you!

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Lindsay Engle

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

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