benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel

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benzoyl peroxide

RxCUI: 358917

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.
42.6%
Plan Coverage
2,159
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 2,159 Medicare Part D plan offerings - 42.6% 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
2,159
Coverage rate
42.6%
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

43 plans
Tier 1, Preferred Generic
57 plans
Tier 2, Generic

Standalone Drug Plans (PDP) Covering benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel

1 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Wellcare Dual Liberty (HMO D-SNP) WELLCARE OF CONNECTICUT, INC. T2 No No $0 CT

Medicare Advantage Plans (MA-PD) Covering benzoyl peroxide 0.05 MG/MG / clindamycin 0.01 MG/MG Topical Gel

99 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
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

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 2,159 Medicare Part D plans (42.6% 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.

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