Medicare Part D coverage · benzoyl peroxide · RxCUI 885131
benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel is covered by 105 Medicare Part D plans (2.1% of enrollable products), averaging Tier 2.4, with prior authorization required on 0% of covering formularies.
- 2.1%
- Plan coverage
- 105
- Plans covering
- T2.4
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel (RxNorm concept RXCUI 885131, generic name benzoyl peroxide) appears on 26 distinct formulary files spanning 105 Medicare Part D plan offerings - 2.1% 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 2.4.
Real-world access to benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 7.7% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 465 Part D beneficiaries filled benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 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 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel today.
Coverage Details
- Formularies covering
- 26
- Plans covering
- 105
- Coverage rate
- 2.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 7.7% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 465
- Total spending
- $437,973
- Avg per beneficiary
- $941.88
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM Health Insurance Company | T2 | No | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM Health Insurance Company | T2 | No | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T2 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T2 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T2 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T2 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T2 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T2 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T2 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T2 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T2 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T2 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T2 | No | $0 | CO |
Show the next 30 plans
| Select Health Medicare Active (HMO) | Selecthealth, Inc. | T2 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T2 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | Selecthealth, Inc. | T2 | No | $0 | NV |
| Troy Medicare (HMO) | Troy Health, Inc. | T2 | No | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Troy Health, Inc. | T2 | No | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | Contra Costa County Medical Service DBA Contra Costa Health | T2 | No | $0 | CA |
| Keystone First VIP Choice (HMO D-SNP) | Vista Health Plan, Inc. | T2 | No | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Vista Health Plan, Inc. | T2 | No | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | Select Health OF South Carolina, Inc. | T2 | No | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T2 | No | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T2 | No | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Florida, Inc. | T2 | No | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Louisiana, Inc. | T2 | No | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas North Carolina, Inc. | T2 | No | $0 | NC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Michigan, Inc. | T2 | No | $0 | MI |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
| Presbyterian Senior Care Plan 2 with Rx (HMO) | Presbyterian Health Plan | T2 | No | $0 | NM |
| Presbyterian Dual Plus (HMO D-SNP) | Presbyterian Health Plan | T2 | No | $0 | NM |
| Presbyterian Senior Care Extra Health Plan with Rx (HMO) | Presbyterian Health Plan | T2 | No | $0 | NM |
| Security Blue HMO-POS Standard (HMO-POS) | Highmark Choice Company | T2 | No | $51.80 | PA |
| Presbyterian Senior Care Plan 3 with Rx (HMO) | Presbyterian Health Plan | T2 | No | $65.80 | NM |
| Freedom Blue PPO Select (PPO) | Highmark Senior Health Company | T2 | No | $95.70 | PA |
| Security Blue HMO-POS Deluxe (HMO-POS) | Highmark Choice Company | T2 | No | $95.90 | PA |
| Freedom Blue PPO Standard (PPO) | Highmark Senior Health Company | T2 | No | $98.20 | PA |
| Freedom Blue PPO Select (PPO) | Highmark Senior Health Company | T2 | No | $115.70 | PA |
| Freedom Blue PPO Deluxe (PPO) | Highmark Senior Health Company | T2 | No | $122.40 | PA |
| Freedom Blue PPO Classic (PPO) | Highmark Senior Health Company | T2 | No | $140.90 | PA |
| Freedom Blue PPO Classic (PPO) | Highmark Senior Health Company | T2 | No | $145.40 | PA |
| Medicare BlueEssential (PPO) | Excellus Health Plan, Inc. | T4 | No | $0 | NY |
| Medicare BlueActive (PPO) | Excellus Health Plan, Inc. | T4 | No | $0 | NY |
Showing top 50 of 98 plans.
Frequently Asked Questions
Is benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel covered by Medicare Part D?
Yes, benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel is covered by 105 Medicare Part D plans (2.1% of all Part D formularies).
What tier is benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel on Medicare Part D plans?
benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel require prior authorization?
0% of Part D formularies require prior authorization for benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel. Step therapy: 7.7%. Quantity limits: 0%.
How much does Medicare spend on benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel?
In 2023, total Medicare Part D spending on benzoyl peroxide 0.025 MG/MG / clindamycin phosphate 0.012 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
Similar prior-authorization rate
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