Does Medicare Cover Divalproex?

In this article...
  • Learn more about what Divalproex is and the medical conditions it treats. Find out about Medicare coverage for this medication, including average co-pays.

Divalproex, also known by its brand name, Depakote, can help prevent seizures for individuals with certain types of epilepsy. This medication also treats manic episodes of bipolar disease and can help prevent migraine headaches. While Divalproex is available in both brand and generic versions, it can still be expensive to purchase.

Fortunately, most Medicare Part D plans cover Divalproex. Medicare Part D is an optional insurance plan that provides prescription drug coverage. Many Part C plans, often referred to as Medicare Advantage, also provide prescription drug coverage. To determine whether your Medicare insurance covers Divalproex, you can check your plan’s formulary, which lists all the medications the plan covers.

Basic Drug Information About Divalproex

Divalproex is available in several forms, including delayed and extended-release tablets, delayed-release sprinkle capsules and IV injections. This medication is typically prescribed for adults and children aged 10 and older. The tablets are taken orally, while capsules can be swallowed or sprinkled over soft foods. Divalproex consists of sodium valproate and valproic acid, which work to increase gamma-aminobutyric acid (GABA), a neurotransmitter, in the brain.

There are multiple drugs that interact negatively with Divalproex. It’s important to discuss all medications you’re taking with your doctor to prevent a dangerous reaction. Divalproex can also cause liver and pancreas damage. Contact your doctor immediately if you experience persistent vomiting or nausea, loss of appetite, darkening of the urine, facial swelling, severe abdominal pain or notice a yellow tint to your skin or white of your eyes.

Other side effects include tremors, blurry vision, weight gain, fatigue, weakness, hair loss and dizziness. Women who are pregnant or trying to become pregnant shouldn't take Divalproex.

How Much Does Divalproex Cost With Medicare?

The cost of Divalproex with Medicare depends on whether you've met your plan's annual deductible. A deductible is the amount of money you must pay every year before your insurance plan kicks in. If you haven’t paid your full deductible for the year, you need to pay the full cost of the drug. However, if you've already met your required deductible, you're only responsible for paying your co-pay.

Your co-pay can be a set amount per prescription or a percentage of the total cost. Check your plan details to determine your specific co-pay amount.

What Tier Is Divalproex?

Most Medicare drug prescription plans include Divalproex in Tier 2 of their formulary. Typically, the higher the tier level, the more expensive the medication is. This factor makes Divalproex a moderately priced prescription medication.

Does Medicare Have Any Restrictions on Coverage?

In some cases, Medicare plans require prior authorization for this medication. This means your physician must contact your insurance provider to explain why this medication is medically necessary. You may also be limited when it comes to the amount of the drug you can receive at one time. For example, if you can only receive a 30-day supply of Divalproex, your doctor may need to renew your prescription each month.

Read More
Woman using calculator to determine costs
Medicare plans offer coverage for Somavert, but prior authorization and co-pays are usually required. ...
Explore the prescription drug Nexterone, learn how it's used to treat heart arrhythmia and find out ...
Wife smiles with husband while visiting him in hospital bed
Brilinta can help reduce your risk of a severe health event, such as a heart attack or stroke. This ...