Medicare Part D coverage · eslicarbazepine acetate · RxCUI 1482523
eslicarbazepine acetate 600 MG Oral Tablet [Aptiom]
Per the CMS 2026 Part D formulary file, eslicarbazepine acetate 600 MG Oral Tablet [Aptiom] is covered by 1,405 Medicare Part D plans (27.8% of enrollable products), averaging Tier 4.3, with prior authorization required on 1.5% of covering formularies.
- 27.8%
- Plan coverage
- 1,405
- Plans covering
- T4.3
- Avg tier
- 1.5%
- Prior auth required
What the CMS Formulary Data Shows for eslicarbazepine acetate 600 MG Oral Tablet [Aptiom]
Per the CMS 2026 Part D formulary file, eslicarbazepine acetate 600 MG Oral Tablet [Aptiom] (RxNorm concept RXCUI 1482523, generic name eslicarbazepine acetate) appears on 68 distinct formulary files spanning 1,405 Medicare Part D plan offerings - 27.8% 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 4.3.
Real-world access to eslicarbazepine acetate 600 MG Oral Tablet [Aptiom] depends on utilization management as much as tier placement: 1.5% of covering formularies require prior authorization. 1.5% require step therapy. 95.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 8,348 Part D beneficiaries filled eslicarbazepine acetate 600 MG Oral Tablet [Aptiom] in 2023, with total plan-and-beneficiary spending of $142,014,028 and an average per-beneficiary annual cost of $17,011.74. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry eslicarbazepine acetate 600 MG Oral Tablet [Aptiom] today.
Coverage Details
- Formularies covering
- 68
- Plans covering
- 1,405
- Coverage rate
- 27.8%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 1.5% of formularies
- Step therapy required
- 1.5% of formularies
- Quantity limits
- 95.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 8,348
- Total spending
- $142,014,028
- Avg per beneficiary
- $17,011.74
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering eslicarbazepine acetate 600 MG Oral Tablet [Aptiom]
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue MedicareRx Value Plus (PDP) | Anthem Insurance Co. & Bcbsma & Bcbsri & Bcbsvt | T4 | No | No | $20.70 | - |
| BlueMedicare Value Rx (PDP) | Usable Mutual Insurance Company | T4 | No | No | $52.50 | - |
Medicare Advantage Plans (MA-PD) Covering eslicarbazepine acetate 600 MG Oral Tablet [Aptiom]
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $22.70 | NY |
| VIVA Medicare Extra Value (HMO D-SNP) | Viva Health, Inc. | T1 | No | $27.70 | AL |
Show the next 30 plans
| VIVA Medicare Extra Care (HMO D-SNP) | Viva Health, Inc. | T1 | No | $27.70 | AL |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) | Elderplan, Inc. | T1 | No | $44.80 | NY |
| MetroPlus Platinum Plan (HMO) | Metroplus Health Plan, Inc. | T1 | No | $58.80 | NY |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | No | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | No | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | No | $0 | OH |
| Aetna Medicare Signature (HMO) | Aetna Health Inc. (GA) | T5 | No | $0 | GA |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T5 | No | $0 | WI |
Showing top 50 of 98 plans.
Frequently Asked Questions
Is eslicarbazepine acetate 600 MG Oral Tablet [Aptiom] covered by Medicare Part D?
Yes, eslicarbazepine acetate 600 MG Oral Tablet [Aptiom] is covered by 1,405 Medicare Part D plans (27.8% of all Part D formularies).
What tier is eslicarbazepine acetate 600 MG Oral Tablet [Aptiom] on Medicare Part D plans?
eslicarbazepine acetate 600 MG Oral Tablet [Aptiom] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 5.
Does eslicarbazepine acetate 600 MG Oral Tablet [Aptiom] require prior authorization?
1.5% of Part D formularies require prior authorization for eslicarbazepine acetate 600 MG Oral Tablet [Aptiom]. Step therapy: 1.5%. Quantity limits: 95.6%.
How much does Medicare spend on eslicarbazepine acetate 600 MG Oral Tablet [Aptiom]?
In 2023, total Medicare Part D spending on eslicarbazepine acetate 600 MG Oral Tablet [Aptiom] was $142,014,028, covering 8,348 beneficiaries. The average spend per beneficiary was $17,011.74.
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
- ceftaroline fosamil 400 MG Injection T4.3
- lomustine 100 MG Oral Capsule [Gleostine] T4.3
- 0.67 ML anakinra 149 MG/ML Prefilled Syringe [Kineret] T4.3
- sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet [Epclusa] T4.3
- 0.25 ML somatropin 4.8 MG/ML Prefilled Syringe [Genotropin] T4.3
- olanzapine 5 MG / samidorphan 10 MG Oral Tablet [Lybalvi] T4.3
Similar prior-authorization rate
- 0.5 ML varicella zoster virus glycoprotein E, recombinant 0.1 MG/ML Prefilled Syringe [Shingrix] 1.5% PA
- simvastatin 80 MG Oral Tablet 1.5% PA
- ribavirin 200 MG Oral Capsule 1.5% PA
- 1000 ML glucose 50 MG/ML / potassium chloride 0.02 MEQ/ML / sodium chloride 9 MG/ML Injection 1.5% PA
- besifloxacin 6 MG/ML Ophthalmic Suspension 1.5% PA
- 50/50 Release 24 HR methylphenidate hydrochloride 20 MG Extended Release Oral Capsule 1.5% PA