Medicare Part D coverage · 24 · RxCUI 2637035
24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly]
Per the CMS 2026 Part D formulary file, 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly] is covered by 68 Medicare Part D plans (1.3% of enrollable products), averaging Tier 3.2, with prior authorization required on 30.8% of covering formularies.
- 1.3%
- Plan coverage
- 68
- Plans covering
- T3.2
- Avg tier
- 30.8%
- Prior auth required
What the CMS Formulary Data Shows for 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly]
Per the CMS 2026 Part D formulary file, 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly] (RxNorm concept RXCUI 2637035, generic name 24) appears on 13 distinct formulary files spanning 68 Medicare Part D plan offerings - 1.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.2.
Real-world access to 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly] depends on utilization management as much as tier placement: 30.8% of covering formularies require prior authorization. 7.7% require step therapy. 38.5% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly] today.
Coverage Details
- Formularies covering
- 13
- Plans covering
- 68
- Coverage rate
- 1.3%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 30.8% of formularies
- Step therapy required
- 7.7% of formularies
- Quantity limits
- 38.5% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly]
68 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $31.20 | DE |
| Prominence Plus (HMO) | Prominence Healthfirst | T3 | No | $0 | NV |
| Prominence Plus (HMO) | Prominence Healthfirst | T3 | No | $0 | NV |
| Prominence Dual (HMO D-SNP) | Prominence Healthfirst | T3 | No | $0 | NV |
| Prominence Dual (HMO D-SNP) | Prominence Healthfirst | T3 | No | $0 | NV |
| Prominence Giveback (HMO) | Prominence Healthfirst | T3 | No | $0 | NV |
| Prominence Plus (HMO) | Prominence Healthfirst OF Florida Inc | T3 | No | $0 | FL |
| Prominence Giveback (HMO) | Prominence Healthfirst OF Florida Inc | T3 | No | $0 | FL |
| Prominence Plus (HMO) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
| Prominence Plus (HMO) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
| Prominence Dual (HMO D-SNP) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
| Prominence Extra Help (HMO) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
Show the next 30 plans
| Prominence Beyond (HMO) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
| Prominence Giveback (HMO) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
| Prominence Giveback (HMO) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
| Prominence Dual (HMO D-SNP) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
| Prominence Beyond (HMO-POS) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
| Prominence Dual (HMO D-SNP) | Prominence Healthfirst OF Florida Inc | T3 | No | $0 | FL |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | Prominence Healthfirst | T3 | No | $0 | NV |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | Prominence Healthfirst OF Florida Inc | T3 | No | $0 | FL |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
| Prominence Diabetes and Heart Care Plus (HMO C-SNP) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | Prominence Healthfirst OF Texas | T3 | No | $0 | TX |
| Prominence Extra Help (HMO) | Prominence Healthfirst | T3 | No | $4.20 | NV |
| Prominence Extra Help (HMO) | Prominence Healthfirst OF Florida Inc | T3 | No | $4.80 | FL |
| Prominence Extra Help (HMO) | Prominence Healthfirst OF Texas | T3 | No | $4.80 | TX |
| Prominence Extra Help (HMO) | Prominence Healthfirst | T3 | No | $9.50 | NV |
| Medicare BlueEssential (PPO) | Excellus Health Plan, Inc. | T4 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | Excellus Health Plan, Inc. | T4 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | Excellus Health Plan, Inc. | T4 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | Excellus Health Plan, Inc. | T4 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | Excellus Health Plan, Inc. | T4 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | Excellus Health Plan, Inc. | T4 | Yes | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T4 | Yes | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T4 | Yes | $0 | NY |
| CDPHP $0 Medicare Rx (HMO) | Capital District Physicians' Health Plan, Inc. | T4 | Yes | $0 | NY |
| Univera SeniorChoice Core (PPO) | Excellus Health Plan, Inc. | T4 | Yes | $33.00 | NY |
| Univera SeniorChoice Advanced (HMO-POS) | Excellus Health Plan, Inc. | T4 | Yes | $36.90 | NY |
| Medicare BlueClassic (PPO) | Excellus Health Plan, Inc. | T4 | Yes | $51.00 | NY |
| Univera SeniorChoice Secure (HMO-POS) | Excellus Health Plan, Inc. | T4 | Yes | $54.90 | NY |
| Medicare BlueBalanced (PPO) | Excellus Health Plan, Inc. | T4 | Yes | $55.00 | NY |
| Medicare Blue Choice Prime (HMO) | Excellus Health Plan, Inc. | T4 | Yes | $55.00 | NY |
Showing top 50 of 68 plans.
Frequently Asked Questions
Is 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly] covered by Medicare Part D?
Yes, 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly] is covered by 68 Medicare Part D plans (1.3% of all Part D formularies).
What tier is 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly] on Medicare Part D plans?
24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly] averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 5.
Does 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly] require prior authorization?
30.8% of Part D formularies require prior authorization for 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly]. Step therapy: 7.7%. Quantity limits: 38.5%.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- 72 HR fentanyl 0.0625 MG/HR Transdermal System T3.2
- betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] T3.2
- molindone hydrochloride 5 MG Oral Tablet T3.2
- degarelix 80 MG Injection [Firmagon] T3.2
- 50 ML penicillin G potassium 40000 UNT/ML Injection T3.2
- 0.25 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega] T3.2
Similar prior-authorization rate
- amitriptyline hydrochloride 10 MG Oral Tablet 30.8% PA
- amitriptyline hydrochloride 25 MG Oral Tablet 30.8% PA
- amitriptyline hydrochloride 100 MG Oral Tablet 30.8% PA
- 72 HR scopolamine 0.0139 MG/HR Transdermal System 30.8% PA
- 5 ML hydromorphone hydrochloride 10 MG/ML Injection 30.5% PA
- zolpidem tartrate 12.5 MG Extended Release Oral Tablet 30.4% PA