• Drugs prescribed for an indication if the FDA has not approved the drug for that indication, except that this exclusion does not apply if our Regional Formulary and Therapeutics Committee determines that the drug is recognized as effective for that use (i) in one of the standard reference compendia, or (ii) in the majority of relevant peer-reviewed medical literature, or (iii) by the Secretary of the U.S. Department of Health and Human Services. • Drugs and supplies ordered from the mail-order pharmacy to addresses outside of Oregon or Washington. • Drugs and supplies that are available without a prescription, even if the nonprescription item is in a different form or different strength (or both), except that this exclusion does not apply to nonprescription drugs or supplies described under "Covered drugs and supplies" in this rider. • Drugs, biological products, and devices that the FDA has not approved. • Drugs prescribed for fertility treatment. • Drugs used for the treatment or prevention of sexual dysfunction disorders. • Drugs used in weight management. • Drugs used to enhance athletic performance. • Extemporaneously compounded drugs, unless the formulation is approved by our Regional Formulary and Therapeutics Committee. • Internally implanted time-release drugs, except that internally implanted time-release contraceptive drugs are covered. • Nutritional supplements. • Outpatient drugs that require professional administration by medical personnel or observation by medical personnel during self-administration (refer instead to the Medical Benefits Chart "Medicare Part B prescription drugs" section for information about drugs that usually are not self-administered). • Replacement of drugs and supplies due to loss, damage, or carelessness. RSARX0124 6