It is possible. The Affordable Care Act limits Medicare Part D coverage for applicable drugs to only those drug manufacturers that have an agreement with the Centers for Medicare and Medicaid Services (CMS) to participate and pay discounts under the
Doughnut Hole discount program.
Because applicable drugs that are not covered under a manufacturer agreement cannot be covered under Part D, Part D plans can NOT cover any such drugs under formulary exceptions (coverage determinations), emergency first fill, or transition policies, unless Medicare has authorized this coverage.
Medicare can authorize coverage for a drug not covered under a manufacturer discount agreement if Medicare determines that the availability of the drug is essential to the health of Part D enrollees.