Does Medicare Cover Tegretol?

In this article...
  • Discover whether your Medicare prescription drug plan will cover Tegretol, and learn about the factors that affect how much you can expect to pay for a refill.

Tegretol is a drug that calms electrical activity in the brain. Doctors prescribe it in tablets for epilepsy and certain mental health conditions. All Medicare prescription drug plans cover Tegretol; as long as you have a Medicare Part D plan or a Medicare Advantage plan with drug coverage, you can rest assured that it will help you manage costs.

Tegretol Drug Information

Tegretol is one of the brand names for the drug carbamazepine. It's an anticonvulsant that's often prescribed to treat seizures, but your doctor may also recommend it to manage acute manic episodes associated with bipolar 1 disorder or the chronic pain condition trigeminal neuralgia. In some cases, doctors prescribe Tegretol off-label to help treat refractory schizophrenia, dementia and restless leg syndrome.

Tegretol works by altering the electrical activity in your brain. When you take it, the medication affects the voltage-gated sodium channels, which help regulate electrical signals. As a result, it reduces the extra electrical activity in your neurons and eases the symptoms of your condition.

What Is the Price of Tegretol With Medicare?

The price you pay for Tegretol depends on your plan. Until you meet your deductible, which could be as little as $0 or as much as $480 in 2022, you'll pay full price for the medication. This amount can be different depending on your location and preferred pharmacy, but you may be able to save money by purchasing generic carbamazepine or another brand. 

Once you meet the deductible, your plan will cover everything but the co-pay. Many plans place Tegretol in Tier 2, which means it's typically a more affordable option.

Does Medicare Place Restrictions on Tegretol?

Tegretol isn't a controlled substance, so it's not subject to many Medicare restrictions. Your plan may limit the number of tablets you can buy at once.

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