Medicare Part D coverage · topiramate · RxCUI 252413
topiramate 50 MG Oral Capsule
Per the CMS 2026 Part D formulary file, topiramate 50 MG Oral Capsule is covered by 4,028 Medicare Part D plans (79.7% of enrollable products), averaging Tier 2.5, with prior authorization required on 2.9% of covering formularies.
- 79.7%
- Plan coverage
- 4,028
- Plans covering
- T2.5
- Avg tier
- 2.9%
- Prior auth required
What the CMS Formulary Data Shows for topiramate 50 MG Oral Capsule
Per the CMS 2026 Part D formulary file, topiramate 50 MG Oral Capsule (RxNorm concept RXCUI 252413, generic name topiramate) appears on 210 distinct formulary files spanning 4,028 Medicare Part D plan offerings - 79.7% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.5.
Real-world access to topiramate 50 MG Oral Capsule depends on utilization management as much as tier placement: 2.9% 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 644,196 Part D beneficiaries filled topiramate 50 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $56,440,596 and an average per-beneficiary annual cost of $87.61. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry topiramate 50 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 210
- Plans covering
- 4,028
- Coverage rate
- 79.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 2.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 644,196
- Total spending
- $56,440,596
- Avg per beneficiary
- $87.61
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering topiramate 50 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T1 | No | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-S1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-V1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete AZ-S001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete VA-Y4 (PPO D-SNP) | Care Improvement Plus South Central Insurance Co. | T1 | No | $0 | VA |
| AARP Medicare Advantage from UHC AL-0001 (HMO-POS) | Unitedhealthcare OF THE Midlands, Inc. | T1 | No | $0 | AL |
| AARP Medicare Advantage from UHC CA-0002 (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| UHC Sharp Medicare Advantage CA-001P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| AARP Medicare Advantage from UHC CA-003P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is topiramate 50 MG Oral Capsule covered by Medicare Part D?
Yes, topiramate 50 MG Oral Capsule is covered by 4,028 Medicare Part D plans (79.7% of all Part D formularies).
What tier is topiramate 50 MG Oral Capsule on Medicare Part D plans?
topiramate 50 MG Oral Capsule averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does topiramate 50 MG Oral Capsule require prior authorization?
2.9% of Part D formularies require prior authorization for topiramate 50 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on topiramate 50 MG Oral Capsule?
In 2023, total Medicare Part D spending on topiramate 50 MG Oral Capsule was $56,440,596, covering 644,196 beneficiaries. The average spend per beneficiary was $87.61.
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
- dexamethasone 1 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension T2.5
- fluorouracil 50 MG/ML Topical Solution T2.5
- haloperidol 5 MG/ML Injectable Solution T2.5
- moxifloxacin 400 MG Oral Tablet T2.5
- 100 ML glucose 50 MG/ML Injection T2.5
- 24 HR desvenlafaxine succinate 50 MG Extended Release Oral Tablet T2.5
Similar prior-authorization rate
- 24 HR rotigotine 0.0417 MG/HR Transdermal System [Neupro] 2.9% PA
- 24 HR rotigotine 0.0833 MG/HR Transdermal System [Neupro] 2.9% PA
- gepotidacin 750 MG Oral Tablet [Blujepa] 2.9% PA
- 24 HR methylphenidate hydrochloride 18 MG Extended Release Oral Tablet 2.9% PA
- 24 HR methylphenidate hydrochloride 27 MG Extended Release Oral Tablet 2.9% PA
- 24 HR methylphenidate hydrochloride 36 MG Extended Release Oral Tablet 2.9% PA