Caplyta savings guide

In this article:

• How much does Caplyta cost?
• How to save money on Caplyta
• Is there a cheaper alternative to Caplyta?

In this article

• How much does Caplyta cost?
• How to save money on Caplyta
• Is there a cheaper alternative to Caplyta?

Caplyta (lumateperone) is a brand-name prescription medication used for schizophrenia and bipolar disorder in adults. Paying for a prescription like Caplyta can add up quickly, especially if you’re uninsured or your insurance plan doesn’t cover it fully. Whether you’re newly prescribed or have been on it a while, understanding your options can help you avoid unnecessary costs. This guide walks through what Caplyta costs, ways to save with or without insurance coverage, and potential lower-cost alternatives to talk to your healthcare provider about. 

How much does Caplyta cost?

The average retail price of Caplyta is $2,250 for 30, 42 mg capsules without insurance. Caplyta is an oral pill dosed once a day. What you actually pay can vary based on your insurance, pharmacy, and dosage prescribed.

According to the drug manufacturer, Johnson & Johnson, Caplyta is covered for about 90% of people with commercial insurance and more than 99% of people with Medicaid and Medicare Part D. However, coverage for Caplyta may not always be straightforward. Many plans may require prior authorization or step therapy first. For example, an AARP Medicare Advantage plan from UnitedHealthcare covers Caplyta only with prior authorization.

In some drug formularies we researched, Caplyta is classified as a specialty drug. This means that even when covered, you may pay higher out-of-pocket costs for Caplyta compared to other medications.

How to save money on Caplyta

If your health insurance plan doesn’t cover Caplyta, there are other ways to save on the medication. These include using coupons or discount cards, joining savings programs, and looking into patient assistance programs. 

1. Free Caplyta coupons

A SingleCare Caplyta coupon can save you close to $600 per month on your prescription. With SingleCare, you could pay $1,653 for 30, 42 mg capsules of Caplyta without using insurance. Costs vary by quantity, strength, form, and the pharmacy that fills your prescription. 

SingleCare coupons are easy to use, and you can use them at many major pharmacies across the country. You can also use the SingleCare app to save on the go.

2. Medicare or Medicaid savings

People who have Medicare or Medicaid coverage may be able to save more on their Caplyta prescriptions. Those with Medicare Part D may be eligible for the low-income subsidy, Medicare Extra Help, for prescription drug coverage. Some people may qualify for Extra Help automatically, but others may have to apply through the Social Security Administration’s (SSA’s) website. 

With Medicare Extra Help, brand-name drugs like Caplyta cost no more than $12.15 in 2025. 

Your state may also have a State Pharmaceutical Assistance Program that may further help with Caplyta costs. People with Medicaid or Medicare plans may be eligible for these programs. 

3. Caplyta savings card

Sometimes drug manufacturers offer savings programs for their brand-name drugs. Johnson & Johnson, the manufacturer of Caplyta, has a savings card program for people with private commercial insurance (not state or federal health plans). People eligible for the program can get the drug for $0 for the first two fills of up to a 30-day supply each. After that, each prescription refill can cost $15 for up to a 90-day supply. 

There are certain criteria to meet to qualify for the savings discount, including:

• Being 18 years or older and being a resident of the United States (excluding Puerto Rico)
• Having a valid prescription for Caplyta
• Having private commercial health insurance, but your insurance doesn’t cover the full cost of the prescription refill
• Not receiving help from Medicaid, Medicare drug benefit, Tricare, or other federal or state health programs

The savings card can be used at participating retail pharmacies. The maximum benefit someone can claim is $600. The program runs through April 30, 2026. 

4. Caplyta patient assistance program

Patient assistance programs may be offered by drug manufacturers for people without insurance coverage. Johnson & Johnson offers a patient assistance program for people who are:

• Over 18 years old and diagnosed with depressive episodes associated with bipolar I or II disorder or schizophrenia
• Not covered by insurance, including Medicare and Medicaid
• A resident of the United States
• Within 300% of the federal poverty level (with an annual household income of $45,180–$125,880, depending on household size)

It’s free to apply to the program, but you have to submit proof of income as part of the application process. People who qualify may receive Caplyta for up to 90 days. After that, they may be eligible to get Caplyta for free for up to a year. 

Is there a cheaper alternative to Caplyta?

Yes. Healthcare providers may prescribe Caplyta because it can be effective in some patients with relatively low side effects. Sharon Batista, MD, a psychiatrist specializing in mood disorders and the assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City, says, “These features make it attractive for patients concerned about metabolic effects, sedation, or tolerability. However, Caplyta remains a brand-only medication with no generic equivalent, which limits access due to high cost and inconsistent insurance coverage.” 

Healthcare providers may prescribe more affordable Caplyta alternatives based on someone’s specific clinical picture. Jaime Waarbroek, a psychiatric mental health nurse practitioner at Neuro Wellness Spa in Los Angeles, California, says, “I often start my patients on alternatives that show comparable efficacy based on trials at dramatically lower costs.” She mentions quetiapine, generic Seroquel, as a common starting point for people with bipolar depression: “I typically start here as it’s the only other FDA-approved treatment for both bipolar I and II depression,” she shares.

However, quetiapine has side effects to be aware of. “Its sedative properties can be beneficial for patients with insomnia or agitation, but weight gain and metabolic risk are significant considerations,” Dr. Batista says.

For people with bipolar depression who experience drowsiness on certain medications, Waarbroek considers lurasidone. “I prescribe this when patients need to avoid sedation,” Dr. Batista says. Though lurasidone may be more costly than other generics, she says it’s still an alternative for “bipolar depression in patients for whom metabolic side effects are a concern.” 

For people with schizophrenia looking for alternatives to Caplyta, Waarbroek considers risperidone, which is the generic form of Risperdal, as her go-to for positive symptoms when cost is a concern. Although it is generally affordable, she emphasizes the need to monitor for extrapyramidal symptoms (EPS) and prolactin elevation. Extrapyramidal symptoms are nervous system-related symptoms that impact muscle control, causing involuntary or repetitive movements.

Bottom line: You have options for affordable mental health treatment

If the cost of Caplyta is too high, reach out to your healthcare provider to discuss other options. They may be able to recommend another effective treatment that fits your budget or help you apply for patient assistance programs. “The best practice when selecting an alternative includes weighing the patient’s psychiatric history, side effect vulnerability (particularly weight and metabolic changes), prior medication response, drug-drug interactions, and insurance or cost barriers,” Dr. Batista says. Managing your health shouldn’t be a financial burden. There are ways to get help. For example, using a SingleCare coupon can help make these options (and Caplyta itself) more affordable at participating pharmacies. SingleCare coupons are free, and many pharmacies accept them.