benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel

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benzoyl peroxide

RxCUI: 244374

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
68.9%
Plan Coverage
3,491
Plans Covering
T3.2
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel

Per the CMS 2026 Part D formulary file, benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel (RxNorm concept RXCUI 244374, generic name benzoyl peroxide) appears on 191 distinct formulary files spanning 3,491 Medicare Part D plan offerings - 68.9% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.2.

Real-world access to benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 29.3% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 465 Part D beneficiaries filled benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel in 2023, with total plan-and-beneficiary spending of $437,973 and an average per-beneficiary annual cost of $941.88. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel today.

Coverage Details

Formularies covering
191
Plans covering
3,491
Coverage rate
68.9%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
29.3% of formularies

2023 Medicare Spending

Beneficiaries
465
Total spending
$437,973
Avg per beneficiary
$941.88

Tier Distribution Across Plans

73 plans
Tier 1, Preferred Generic
27 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 No $0 FL
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 No $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 No $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 No $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 No $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 No $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 No $0 NY
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T1 No $0 CA
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 No $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 No $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 No $0 NM
Horizon NJ TotalCare (HMO D-SNP) HORIZON HEALTHCARE OF NEW JERSEY, INC. T1 No $0 NJ
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 No $0 CA
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
CCA One Care (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
CCA Senior Care Options (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Provider Partners Pennsylvania Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 No $0 PA
Provider Partners North Carolina Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 No $0 NC
Provider Partners Indiana Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 No $0 IN
Provider Partners Maryland Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $0 MD
Provider Partners Missouri Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $0 MO
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI
Platino Blindao (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
Platino Enlace (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
PLATINO ADVANCE (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
PLATINO PLUS (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T1 No $0 CA
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 No $0 DE
Florida Complete Care (HMO I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 No $4.80 TX
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 No $4.80 FL
Provider Partners Texas Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. T1 No $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 No $5.00 OK

Frequently Asked Questions

Is benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel covered by Medicare Part D?

Yes, benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel is covered by 3,491 Medicare Part D plans (68.9% of all Part D formularies).

What tier is benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel on Medicare Part D plans?

benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.

Does benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel require prior authorization?

0% of Part D formularies require prior authorization for benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel. Step therapy: 0%. Quantity limits: 29.3%.

How much does Medicare spend on benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel?

In 2023, total Medicare Part D spending on benzoyl peroxide 0.05 MG/MG / erythromycin 0.03 MG/MG Topical Gel was $437,973, covering 465 beneficiaries. The average spend per beneficiary was $941.88.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial