MedicarePartD.guide

A non-government resource built from CMS public data

EPRONTIA 25 mg/mL Solution

Also known as Topiramate. Coverage in Oregon and Washington (CMS PDP Region 30).

8 of 10 stand-alone Part D plans in Oregon and Washington cover this drug on tier 4.

6 of 8 plans apply a prior authorization, step therapy or quantity limit.

91 Medicare Advantage plans in OR, WA do cover it

Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. OR: 26 plans · WA: 65 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$1.5947—
  • Prior authorization
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug33%—$1.6097$77.2748 units
  • Prior authorization
  • Quantity limit 48 per 30 days
Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible4Non-Preferred Drug33%—$1.6097$77.2748 units
  • Prior authorization
  • Quantity limit 48 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible4Non-Preferred Drug36%—$2.8884—None
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$1.5993—
  • Prior authorization
SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$1.6547$79.4348 units
  • Prior authorization
  • Quantity limit 48 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$1.6097$77.2748 units
  • Prior authorization
  • Quantity limit 48 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible4Non-Preferred Drug37%—$2.8884—None

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.

See coverage in all 39 regions →