Lamotrigine (Lamictal) Medicare Coverage

Lamotrigine
Chemical name: Lamotrigine

Brand name: Lamictal

Typical dosage: 100mg

Typical type: Tablet1

Lamotrigine is a medication used to treat bipolar disorder and certain types of seizures. Lamotrigine comes as a brand name drug or as a generic and is an oral tablet.

Lamotrigine is a medication used to treat bipolar disorder, focal seizures and generalized onset seizures associated with epilepsy and Lennox-Gastaut Syndrome. The brand name equivalent of Lamotrigine is called Lamictal.

Lamotrigine is typically taken once daily. It stops the release of a substance called glutamate that excites the brain, and it helps stabilize neurons.

Common side effects include dizziness, drowsiness, upset stomach, fatigue, shakiness, insomnia, nose or throat irritation, diarrhea, constipation, weight loss, dry mouth and back pain.

Does Medicare cover Lamotrigine or Lamictal?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Lamotrigine.1

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.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 Lamotrigine.

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Average costs for Lamotrigine with Medicare drug coverage1

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.		 After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.
$2 – $21 Free – $20

Additional information

Take Lamotrigine regularly and do not change your dose without talking to your doctor. Taking a different dose than your doctor prescribed could result in you having a seizure.

Lamotrigine can lead to a bad skin reaction called Stevens-Johnson Syndrome, also called toxic epidermal necrolysis. This can cause irreversible health problems and even death.

Go to the hospital if you experience skin that is red, blistered, swollen, or peeling; red or irritated eyes; or sores in the mouth, throat, nose or eyes. In most cases, the skin reaction happens within 2-8 weeks of starting Lamotrigine.

Thoughts of suicide can be increased while taking Lamotrigine. If you start taking this medication and have any signs of decreased mood, panic attacks or other negative changes in mood, call your doctor right away.

Lamotrigine can cause hormone-based birth control (pills, patch, ring, etc.) to work less effectively. Be sure to use a second form of birth control while taking Lamotrigine to avoid pregnancy.

 

 

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.