Does Medicare Cover Gabapentin? Which Part Pays and What the Tier Means

Yes. Medicare covers gabapentin, and the part that pays is Part D, the drug benefit. Gabapentin comes as capsules, tablets, and a liquid that you take by mouth at home. Drugs you take at home sit in Part D, so your drug plan is where coverage lives.

Gabapentin is used for nerve pain, such as the pain that can follow shingles, and with other drugs to help control some seizures. This guide covers the payment side only: which part pays, where the drug sits on plan drug lists, and what that spot means for your cost. It does not give dosing advice, and it does not say if this drug is right for any one person. Those calls belong to you and your doctor. You can see the full data for this drug on our gabapentin page.

Which part pays

Medicare splits drug coverage by where and how a drug is given.

The full list of covered drugs lives on our medications hub.

• Part D: pays for gabapentin you take at home. This is the normal path for this drug.
• Part A: covers drugs given during a covered hospital or skilled stay, as part of that stay. If you take gabapentin in a hospital, it is inside the stay's payment.
• Part B: pays for some drugs a clinician gives in an office or clinic. Gabapentin has no such form in the CMS Part B spending file, so Part B is not a path for this drug.
• Medicare Advantage: most plans with drug coverage use the same drug list and tier system as other Part D plans. The plan's own list decides your cost.
• Medigap: Medicare Supplement plans sold today do not include drug coverage. Drug coverage comes from Part D or from a Medicare Advantage plan with drug coverage.

What a tier is

Each Part D plan keeps a drug list, called a formulary. The plan sorts the drugs on its list into tiers, which are cost levels. Low tiers cost less. High tiers cost more.

The tier is the honest cost signal for a drug. CMS does not publish a copay for gabapentin, because each plan sets its own price for its tier. Two plans can place the same drug on the same tier and charge sums that are not the same.

• Tier 1 is most often for low-cost generic drugs, with the lowest copays.
• Tier 2 is most often for preferred brand drugs or higher-cost generics. Many plans set a flat copay for this tier.
• Tier 3 and above cost more, and some plans charge a share of the drug's price, called coinsurance, on these tiers.
• A specialty tier holds very high-cost drugs, and it almost always uses coinsurance.

Where gabapentin sits

The data here comes from the CMS monthly Part D formulary file for plan year 2027, checked on 2026-10-30. The file covers 5,495 Part D plans.

So the usual case is Tier 2. If your plan is one of the Tier 1 plans, your cost should be lower. If it is a Tier 3 plan, expect to pay more. Check your own plan's list before the year starts, and again if the plan sends a change notice.

• All 5,495 plans list gabapentin. The listing share is 100%.
• The most common tier is Tier 2. Of the listing plans, 3,855 place it on Tier 2, which is about 70%.
• The rest spread out: 868 plans place it on Tier 1, 742 on Tier 3, and 30 on Tier 4.

What you may pay across the year

Your cost for gabapentin is not just the tier copay. Part D has stages, and the sums below come from the Verified Figures Ledger.

Coverage and costs change. Drug lists (formularies), tiers, and copays can change during the year and differ by plan. Always check with your insurance company or plan directly to confirm what is covered and what you will pay.

• Deductible: the standard Part D deductible is capped at $615 for 2026. Your plan can set a lower one, and some plans waive it for low tiers. For 2027, the cap rises to $700.
• Coverage stage: after the deductible, you pay your tier copay or coinsurance, and the plan pays the rest, until your total out-of-pocket cost for covered drugs hits the cap.
• Cap: for 2026, once your out-of-pocket cost for covered drugs reaches $2,100, you pay $0 for covered drugs for the rest of the year. For 2027, the cap is $2,400.
• Extra Help: if you qualify for Extra Help with drug costs, you pay no more than $5.10 for a generic drug and no more than $12.65 for other drugs in 2026. Gabapentin is a generic drug. Our guide to checking Medicare Savings Programs and Extra Help shows how to check if you qualify.

Sample situation

Rosa takes gabapentin for nerve pain in her feet. Each fall, she reviews her drug plan before the new year. This year, her plan's letter said her drugs would stay on the same tiers. Rosa did not stop there. She called the plan and asked two things: is gabapentin still on Tier 2 in the new year, and does the deductible apply to Tier 2 drugs in her plan?

The plan told her the tier would stay Tier 2, and her plan waives the deductible for Tier 2. Her copay would stay a flat sum each month. She also learned that what she pays counts toward the $2,100 out-of-pocket cap for 2026, so a costly drug she takes for a short course in the spring would move her closer to the stage where covered drugs cost her $0.

Rosa's check took one phone call. It told her what the drug would cost, month by month, with no shock at the pharmacy counter in January.

How to check your own plan

• Find your plan's drug list online or in the plan's mailed book, and look up gabapentin by name and strength.
• Note the tier, and then find what your plan charges for that tier in its summary of benefits.
• Ask if the deductible applies to that tier in your plan.
• Ask the pharmacy what the drug costs with your plan before you fill a three-month supply. Small sums add up over a year.

Sources

• https://careandlivingguide.com/medications/gabapentin
• https://www.medicare.gov/health-drug-plans/part-d/basics/costs
• https://www.medicare.gov/basics/costs/help/drug-costs