Xcopri and Medicare: Coverage and Cost

Xcopri (cenobamate) is a Schedule V antiseizure prescription tablet that treats partial onset seizures in adults. This seizure type affects a single brain area rather than causing widespread electrical activity. Medicare drug plans generally cover Xcopri or a comparable alternative.

Because many Medicare Part D and Medicare Advantage Prescription Drug (MAPD) plans must cover most medications from six protected categories, including anticonvulsants for seizure treatment, many such plans should cover Xcopri.

Private insurers manage these plans, so coverage depends on each plan’s formulary. However, if a plan excludes Xcopri, it typically covers a comparable alternative.

The out-of-pocket cost of Xcopri without insurance depends on the dose and pharmacy, but it typically averages around $1,300.

Under Medicare drug plans, a person’s cost varies by tier. Higher tier drugs generally require larger copayments, while lower, more affordable tiers tend to include generic drugs. However, there is no generic version of Xcopri.

Medicare may cap a person’s annual prescription costs at $2,000 in 2025, though this cap may rise to $2,100 in 2026. This means a person’s plan may cover all expenses beyond this spending limit.

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Medicare drug plans may have deductibles and monthly premiums, which depend on the plan. However, deductibles cannot exceed $590 in 2025.

To lower their costs, people can consider enrolling in the trial program offered by Xcopri’s manufacturer, which provides a free 1-month supply. People can also explore resources such as the Medicine Assistance Tool and NeedyMeds.