Medicare Part D coverage · lamotrigine · RxCUI 311264
lamotrigine 25 MG Tablet for Oral Suspension
Per the CMS 2026 Part D formulary file, lamotrigine 25 MG Tablet for Oral Suspension is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 2.2, with prior authorization required on 0% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T2.2
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for lamotrigine 25 MG Tablet for Oral Suspension
Per the CMS 2026 Part D formulary file, lamotrigine 25 MG Tablet for Oral Suspension (RxNorm concept RXCUI 311264, generic name lamotrigine) appears on 328 distinct formulary files spanning 5,052 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.2.
Real-world access to lamotrigine 25 MG Tablet for Oral Suspension depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 611,083 Part D beneficiaries filled lamotrigine 25 MG Tablet for Oral Suspension in 2023, with total plan-and-beneficiary spending of $70,895,194 and an average per-beneficiary annual cost of $116.02. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry lamotrigine 25 MG Tablet for Oral Suspension today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 611,083
- Total spending
- $70,895,194
- Avg per beneficiary
- $116.02
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering lamotrigine 25 MG Tablet for Oral Suspension
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun MediMax (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
Show the next 30 plans
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Extra (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply More Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply More Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is lamotrigine 25 MG Tablet for Oral Suspension covered by Medicare Part D?
Yes, lamotrigine 25 MG Tablet for Oral Suspension is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is lamotrigine 25 MG Tablet for Oral Suspension on Medicare Part D plans?
lamotrigine 25 MG Tablet for Oral Suspension averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does lamotrigine 25 MG Tablet for Oral Suspension require prior authorization?
0% of Part D formularies require prior authorization for lamotrigine 25 MG Tablet for Oral Suspension. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on lamotrigine 25 MG Tablet for Oral Suspension?
In 2023, total Medicare Part D spending on lamotrigine 25 MG Tablet for Oral Suspension was $70,895,194, covering 611,083 beneficiaries. The average spend per beneficiary was $116.02.
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
Similar prior-authorization rate
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