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

Verify with CMS →

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.

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

9 plans
Tier 1, Preferred Generic
41 plans
Tier 2, Generic
50 plans
Tier 4, Non-Preferred

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.

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.

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