TOPIRAMATE ER

100 MG, 150 MG, 200 MG, 25 MG, 50 MG — CAPSULE, EXT RELEASE 24 HR

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Oct 15, 2026  ·  Checked: 11 hours, 15 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Silver CMS Standard Tier 3 - Preferred Brand — — — None
Connect myDiabetesCare Silver Tier 3 - Preferred Brand — — — None
Connect Silver 3600 Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Connect Bronze CMS Standard Tier 3 - Preferred Brand — — — None
Connect Gold CMS Standard Tier 3 - Preferred Brand — — — None
Connect Bronze RD 6000 Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Connect Bronze RD CMS Standard Tier 3 - Preferred Brand — — — None
Connect Silver RD 3500 Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Connect Silver RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Connect Silver RD CMS Standard Tier 3 - Preferred Brand — — — None
Connect Silver RD 2200 Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Connect Gold RD CMS Standard Tier 3 - Preferred Brand — — — None
Connect Bronze 7000 HSA Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Connect Silver 5000 Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Connect myDiabetesCare Bronze Tier 3 - Preferred Brand — — — None
Connect Gold 1500 Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Connect Bronze 6500 Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Connect Bronze RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Connect Silver 3000 Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Connect Bronze 5500 Indiv Med Deductible Tier 3 - Preferred Brand — — — None
Source: CMS QHP JSON  ·  Formulary date: Sep 16, 2026  ·  Checked: 11 hours, 15 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Aetna Medicare Dual (HMO D-SNP) Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (HMO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (HMO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Value Plus (HMO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Prime (HMO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature Care (HMO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Full Dual Care (HMO D-SNP) Tier 4 - Non-Preferred — — — None
Aetna Medicare Chronic Care (HMO C-SNP) Tier 4 - Non-Preferred — — — None
Aetna Medicare Enhanced (HMO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Chronic Care Value (HMO C-SNP) Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Enhanced (PPO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Enhanced (PPO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature Extra (PPO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature Giveback (PPO) Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — — None
Source: Excel (XLSX)  ·  Formulary date: Sep 23, 2026  ·  Checked: 11 hours, 15 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 1 - Generic Formulary ✓ — — PA PA: 1270/48001/90693 PA DRUGS, DOD PA REQUIRED
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