Medicare Part D coverage · benzoyl peroxide · RxCUI 358917
benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel is covered by 2,158 Medicare Part D plans (42.7% of enrollable products), averaging Tier 2.7, with prior authorization required on 0% of covering formularies.
- 42.7%
- Plan coverage
- 2,158
- Plans covering
- T2.7
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel (RxNorm concept RXCUI 358917, generic name benzoyl peroxide) appears on 113 distinct formulary files spanning 2,158 Medicare Part D plan offerings - 42.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.7.
Real-world access to benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 1.8% require step therapy. 5.3% 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 / clindamycin 0.01 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 / clindamycin 0.01 MG/MG Topical Gel today.
Coverage Details
- Formularies covering
- 113
- Plans covering
- 2,158
- Coverage rate
- 42.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 1.8% of formularies
- Quantity limits
- 5.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 465
- Total spending
- $437,973
- Avg per beneficiary
- $941.88
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
Show the next 30 plans
| 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 |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| 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 |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | No | $5.00 | OK |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | No | $32.70 | WV |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP Inc. | T1 | No | $38.40 | IN, MD, OH |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T1 | No | $51.60 | NY |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $58.80 | NY |
| HAP Medicare Explore (PPO) | Alliance Health AND Life Insurance Company | T2 | No | $0 | MI |
| HAP Medicare Prime (PPO) | Alliance Health AND Life Insurance Company | T2 | No | $0 | MI |
| HAP Medicare Connect (HMO) | Health Alliance Plan OF Michigan | T2 | No | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | Health Alliance Plan OF Michigan | T2 | No | $0 | MI |
| HAP Medicare Superior (HMO) | Health Alliance Plan OF Michigan | T2 | No | $0 | MI |
| Henry Ford Select (HMO) | Health Alliance Plan OF Michigan | T2 | No | $0 | MI |
| Troy Medicare (HMO) | Troy Health, Inc. | T2 | No | $0 | NC |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel covered by Medicare Part D?
Yes, benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel is covered by 2,158 Medicare Part D plans (42.7% of all Part D formularies).
What tier is benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel on Medicare Part D plans?
benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel require prior authorization?
0% of Part D formularies require prior authorization for benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel. Step therapy: 1.8%. Quantity limits: 5.3%.
How much does Medicare spend on benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel?
In 2023, total Medicare Part D spending on benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel was $437,973, covering 465 beneficiaries. The average spend per beneficiary was $941.88.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- 12 HR carbamazepine 200 MG Extended Release Oral Tablet T2.7
- 100 ML fluconazole 2 MG/ML Injection T2.7
- Augmented betamethasone 0.5 MG/ML Topical Lotion T2.7
- amylase 180000 UNT / lipase 36000 UNT / protease 114000 UNT Delayed Release Oral Capsule [Creon] T2.7
- 2 ML clindamycin 150 MG/ML Injection T2.7
- 0.5 ML tirzepatide 10 MG/ML Auto-Injector [Mounjaro] T2.7
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA