lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal]
lamotrigine
RxCUI: 849049
What the CMS Formulary Data Shows for lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal]
Per the CMS 2026 Part D formulary file, lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal] (RxNorm concept RXCUI 849049, generic name lamotrigine) appears on 3 distinct formulary files spanning 21 Medicare Part D plan offerings - 0.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.
Real-world access to lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 66.7% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 611,083 Part D beneficiaries filled lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal] in 2023, with total plan-and-beneficiary spending of $70,895,417 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 100 MG Disintegrating Oral Tablet [Lamictal] today.
Coverage Details
- Formularies covering
- 3
- Plans covering
- 21
- Coverage rate
- 0.4%
- Tier range
- Tier 4, Non-Preferred
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 66.7% of formularies
2023 Medicare Spending
- Beneficiaries
- 611,083
- Total spending
- $70,895,417
- Avg per beneficiary
- $116.02
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal]
21 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Active (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T4 | No | $0 | MS |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $47.00 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $59.70 | PA |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $63.50 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $79.70 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T4 | No | $102.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T4 | No | $112.70 | PA |
Frequently Asked Questions
Is lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal] covered by Medicare Part D?
Yes, lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal] is covered by 21 Medicare Part D plans (0.4% of all Part D formularies).
What tier is lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal] on Medicare Part D plans?
lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.
Does lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal] require prior authorization?
0% of Part D formularies require prior authorization for lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal]. Step therapy: 0%. Quantity limits: 66.7%.
How much does Medicare spend on lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal]?
In 2023, total Medicare Part D spending on lamotrigine 100 MG Disintegrating Oral Tablet [Lamictal] was $70,895,417, covering 611,083 beneficiaries. The average spend per beneficiary was $116.02.
Read our methodology - how this data is sourced, computed, and verified.