FillMapSimply Level (HMO C-SNP)

Does Simply Level (HMO C-SNP) cover lamotrigine?

Simply Level (HMO C-SNP)
H5471-073-0 · MA_LOCAL · Medicare Part D
lamotrigine
Do you get help with your Medicare drug costs?None of these

Optional. Some plans charge less at a preferred pharmacy. Enter your ZIP to see which pharmacies near you take this plan — pick yours and the price above is re-worked for it. Until you do, we show what a standard pharmacy costs. Nothing here is saved.

lamotrigineunder Simply Level (HMO C-SNP)
Covered — some forms require prior authorization
3 of 21 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$0per 30-day fill

Part D caps what you pay out of pocket at $2,100 for 2026. From the first fill — no deductible on this drug.

This plan charges the same at every pharmacy in its network — where you fill it will not change this figure.

Tier
Tier 1
Approval first
Required
Try another first
No
Amount limit
None
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 16, 2026 · CMS Part D monthly PUF. Reference information, not medical advice and not a price.

Covered forms and strengths (21)

  • {14 (24 HR lamotrigine 100 MG Extended Release Oral Tablet [Lamictal]) / 7 (24 HR lamotrigine 200 MG Extended Release Oral Tablet [Lamictal]) / 14 (24 HR lamotrigine 50 MG Extended Release Oral Tablet [Lamictal]) } Pack [Lamictal XR Green Patient Titration Kit (for Patients Taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone, and Not Taking Valproate)]Tier 5Approval first
  • {14 (lamotrigine 100 MG Oral Tablet) / 84 (lamotrigine 25 MG Oral Tablet) } PackTier 5
  • {21 (24 HR lamotrigine 25 MG Extended Release Oral Tablet [Lamictal]) / 7 (24 HR lamotrigine 50 MG Extended Release Oral Tablet [Lamictal]) } Pack [Lamictal XR Blue Patient Titration Kit (for Patients Taking Valproate)]Tier 4Approval first
  • {35 (lamotrigine 25 MG Oral Tablet) } PackTier 2
  • {7 (24 HR lamotrigine 100 MG Extended Release Oral Tablet [Lamictal]) / 14 (24 HR lamotrigine 25 MG Extended Release Oral Tablet [Lamictal]) / 14 (24 HR lamotrigine 50 MG Extended Release Oral Tablet [Lamictal]) } Pack [Lamictal XR Orange Patient Titration Kit (for Patients Not Taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate)]Tier 4Approval first
  • {7 (lamotrigine 100 MG Oral Tablet) / 42 (lamotrigine 25 MG Oral Tablet) } PackTier 2
  • lamotrigine 10 MG/ML Oral Suspension [Subvenite]Tier 5
  • lamotrigine 100 MG Disintegrating Oral TabletTier 2
  • lamotrigine 100 MG Oral TabletTier 1
  • lamotrigine 100 MG Oral Tablet [Subvenite]Tier 4
  • lamotrigine 150 MG Oral TabletTier 1
  • lamotrigine 150 MG Oral Tablet [Subvenite]Tier 4
  • lamotrigine 200 MG Disintegrating Oral TabletTier 2
  • lamotrigine 200 MG Oral TabletTier 1
  • lamotrigine 200 MG Oral Tablet [Subvenite]Tier 4
  • lamotrigine 25 MG Disintegrating Oral TabletTier 2
  • lamotrigine 25 MG Oral TabletTier 1
  • lamotrigine 25 MG Oral Tablet [Subvenite]Tier 4
  • lamotrigine 25 MG Tablet for Oral SuspensionTier 1
  • lamotrigine 5 MG Tablet for Oral SuspensionTier 2
  • lamotrigine 50 MG Disintegrating Oral TabletTier 2

← All coverage for lamotrigine