Does Medicare Cover Trileptal?

In this article...
  • Find out whether Medicare Part D covers the anticonvulsant drug Trileptal, and explore typical coverage restrictions and out-of-pocket costs in this article.

Trileptal is a relatively inexpensive medication, but the costs can mount up if you need to take it for extended periods. Below, you can find out whether Medicare covers Trileptal and learn about typical co-pays and coverage restrictions. 

What Is Trileptal?

Trileptal is a branded medication containing oxcarbazepine. Oxcarbazepine is an anticonvulsant that normalizes electrical activity in the brain to control epileptic seizures. Doctors usually only prescribe Trileptal to adults and children aged 6 or older. It's also occasionally used to treat bipolar disorder. 

Most people start on a low dose of Trileptal, and their doctor may gradually increase their dose until their symptoms improve. Most people take this medication twice per day, but you should follow your doctor's advice, as dosage requirements can vary from person to person. 

Potential side effects of Trileptal include:

  • Rapid, uncontrollable eye movements
  • Nausea and vomiting
  • Weight gain
  • Headache
  • Muscle weakness or tension
  • Diarrhea or constipation
  • Sweating
  • Coordination problems
  • Excessive thirst

Does Medicare Cover Trileptal?

Anticonvulsant drugs are protected medications, which means all Medicare plans must cover them. Therefore, 100% of Medicare prescription drug coverage policies (Medicare Part D) cover oxcarbazepine, but they may not cover the Trileptal brand. Your plan's formulary (the list of covered drugs) can tell you whether your insurer covers your medication. Formularies vary by provider, but most place Trileptal under Tier 2. 

If your plan excludes Trileptal, it's worth asking your doctor if you can use the brand covered by your policy or generic oxcarbazepine. For example, your policy may cover a Trileptal alternative called Oxtellar XR.

How Much Does Trileptal Cost With Medicare?

The average retail price of 60 300-milligram Trileptal tablets is $87.88. However, some pharmacies may charge more or less than average, and using medication coupons could significantly reduce the cost. 

Enrollees generally pay for prescription drugs until they've paid their Part D deductible. The maximum legal deductible is $480, but some insurers may set lower or even zero deductibles. After that, you'll usually pay a co-pay of up to $2 for your Trileptal prescription. However, some plans don't charge co-pays for Trileptal and other oxcarbazepine medications. 

Does Medicare Impose Coverage Restrictions for Trileptal?

Coverage restrictions, such as prior authorization requirements or quantity limits, are unusual for Trileptal. However, it's worth checking with your provider to see if you need to satisfy any eligibility criteria. 

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