Does Medicare Cover Topamax?

Christian Worstell
In this article...
  • Topamax is a branded anticonvulsant medication used to treat seizures in people with epilepsy. Explore how Medicare coverage for Topamax and topiramate works.

If you need to take anticonvulsant medication long-term, having the right prescription drug insurance can help reduce the impact on your wallet. This guide explores Medicare coverage for Topamax and other topiramate medications. 

What Is Topamax?

Topamax is a branded version of the generic medication topiramate. Doctors sometimes prescribe topiramate medications to reduce or prevent epileptic seizures in adults and children. It's also used to prevent migraines.

Topiramate is an anticonvulsant drug. It works by reducing abnormal brain activity to minimize the risk of tonic-clonic and partial-onset seizures. This medication comes in the form of tablets, sprinkle capsules and liquids and is available in generic forms. Branded versions include Topamax and the following:

  • Eprontia
  • Qudexy XR
  • Trokendi XR

Most people take one or two doses of Topamax each day with or without food. Your doctor may tell you to take your medication at the same time each day to improve its efficacy and reduce the risk of side effects. 

Topamax Side Effects

This medication can harm unborn babies, so your doctor may recommend using contraception when taking Topamax and changing to a different medication during pregnancy. Occasionally, this medication can cause mental health problems, which may include suicidal thoughts. Other possible side effects include:

  • Numb or tingling hands and feet
  • Weight loss
  • Acid reflux
  • Nosebleeds
  • Changes in the menstrual cycle
  • Uncontrollable shaking or eye movements
  • Headache
  • Weakness

Does Medicare Cover Topamax?

Original Medicare (Parts A and B) doesn't usually cover Topamax. However, you may have coverage if you're a Medicare Part D enrollee or have a Medicare Advantage plan with prescription drug coverage. 

All Part D plans cover generic topiramate, although it's unclear how many plans pay for the Topamax brand. Your policy's formulary (covered medication list) can tell you which topiramate drugs your insurer covers. Medications containing topiramate generally fall under Tier 1.

Coverage for Topamax is usually unrestricted. Therefore, most insurers don't require prior authorization or set quantity restrictions for this medication.

How Much Does Topamax Cost With Medicare?

Original Medicare enrollees must pay for Topamax out of pocket unless they also have supplemental Part D coverage. People with Medicare Part D or Medicare Advantage coverage pay for their medications until they satisfy their deductibles unless they have a deductible-free plan. 

Topamax costs vary greatly depending on where you live and the pharmacy you use. In some areas, the cost of 30 25-milligram pills may range between $9 and $139. As the retail price range for Topamax is relatively wide, it could be worth shopping around to find the most affordable option. You could also try searching for discount vouchers to reduce the cost of Topamax. 

Some insurance companies cover the entire cost of Topamax prescriptions once you've met your deductible. If your insurer charges co-pays, they're usually nominal. Topamax co-pays are usually $1 or less. 

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with 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.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at

Read More
Woman gets help at pharmacy
Rituxan is an injectable medication used to help treat and manage a variety of medical conditions, ...
Holding Hands Providing Comfort
If your doctor prescribes Nardil to treat depression, you may wonder if your insurance will cover ...
A doctor smiles and speaks with her patient
Find out whether Medicare prescription drug plans offer coverage for pravastatin. Discover what this ...