Topamax (topiramate) is a medication prescribed to help prevent migraine and manage seizures in people with epilepsy. The drug is available in tablet form or as a sprinkle capsule, and experts classify it as an anticonvulsant drug.
Medicare drug plans may cover Topamax. But whether they do or not, your out-of-pocket costs and coverage depend on your specific plan.
Medicare coverage for prescription drugs is available through a stand-alone Medicare Part D plan or a Medicare Advantage prescription drug (MAPD) plan. Private insurance companies administer these plans, which have different coverage options and costs.
Whether your plan covers Topamax or not depends on its formulary, a list of all covered drugs. All Medicare drug plans must cover most drugs in six protected categories, including anticonvulsants. This means most plans are likely to cover Topamax.
Even if your plan doesn’t cover the branded drug, it may cover the generic version. If the plan doesn’t cover it all, it may cover an alternative with similar effectiveness.
Without insurance, 60 Topamax tablets of 50 milligrams (mg) cost more than $800. The generic drug is much more affordable, ranging from $9 to about $60, depending on the pharmacy. Alternative doses or versions of the drug, such as the extended-release form, have different pricing.
How much you may pay after drug coverage kicks in depends on the tier in which your plan classifies the drug in its formulary.
Often, generic medications fall in lower tiers, making them more affordable. With a Medicare drug plan, you may never spend more than $2,000 out of pocket on prescription drugs annually in 2025.
After reaching this cap, your plan may fully cover the remainder of your yearly expenses. This limit changes each year. In 2026, the limit may increase to $2,100. Also, no Medicare drug plan can have a deductible exceeding $590 in 2025.
For help with costs, check out the Topamax Savings Program from the drug’s manufacturer. Just remember, you cannot use your Medicare coverage with this discount. You can compare your costs under both options to select the one that costs the least.