Topamax (Topiramate) Medicare Coverage

Topamax contains the active medication Topiramate. Topamax is used to prevent migraines and is also used to treat seizure disorders, including focal onset or primary generalized tonic-clonic seizures.

Topamax is typically taken once daily.

Common side effects of Topamax include constipation, diarrhea, upset stomach, change in taste, excitability, dizziness, sleepiness, headache, flushing and signs of a common cold.

How much does Topiramate cost with Medicare Advantage plans?

Topiramate coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.

Contact your plan carrier or consult your plan formulary for more cost information.

Does Medicare cover Topiramate?

According to GoodRx, 100% of Medicare Advantage plans and Medicare Part D plans covered Topiramate, the generic form of Topamax, in 2023.¹

• Medicare Advantage plans or Part D plans that cover Topiramate include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug coverage kicks in.
  
  
• Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). 89% of 2023 Medicare Advantage plans included prescription drug coverage.²
  
  
• Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Topiramate. We represent carriers such as Humana, Aetna, UHC, Anthem BCBS, Wellcare, Cigna Healthcare, and Kaiser Permanente.

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Additional information

Do not stop taking Topamax suddenly without talking to your doctor. Stopping this medication suddenly can increase your risk of seizures. You will want to slowly stop Topamax over time with the help of your doctor.

Topamax can increase the amount of acid in the blood. This condition is called lactic acidosis. Signs of too much acid in the blood include confusion, rapid breathing, abnormal heartbeat, upset stomach, shortness of breath and fatigue.

Topamax can also increase the risk of infection while you take it. Signs of infection include fever, chills, sore throat, cough or sinus and ear pain.

Contact your doctor if you feel any of the above side effects or if you notice other abnormal adverse effects.

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

Written by Hayden Gharibyar, Pharm.D.