Does Medicare Cover Tegretol?

Christian Worstell | January 02, 2024

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 $545 in 2024, 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.

About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

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