Medicare Part D coverage · benzoyl peroxide · RxCUI 1540241

benzoyl peroxide 0.05 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel

Per the CMS 2026 Part D formulary file, benzoyl peroxide 0.05 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel is covered by 2,726 Medicare Part D plans (54% of enrollable products), averaging Tier 2.4, with prior authorization required on 0% of covering formularies.

54%
Plan coverage
2,726
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 0.05 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel

Per the CMS 2026 Part D formulary file, benzoyl peroxide 0.05 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel (RxNorm concept RXCUI 1540241, generic name benzoyl peroxide) appears on 124 distinct formulary files spanning 2,726 Medicare Part D plan offerings - 54% 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 2.4.

Real-world access to benzoyl peroxide 0.05 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. 0% require step therapy. 50.8% 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 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 0.05 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel today.

Coverage Details

Formularies covering
124
Plans covering
2,726
Coverage rate
54%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
50.8% of formularies

2023 Medicare Spending

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

Tier Distribution Across Plans

55 plans
Tier 1, Preferred Generic
45 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering benzoyl peroxide 0.05 MG/MG / clindamycin phosphate 0.012 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
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
Show the next 30 plans
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 Missouri Community Plan (HMO I-SNP) Provider Partners Health Plan OF Missouri, Inc. T1 No $0 MO
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
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
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
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
Provider Partners Illinois Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Illinois T1 No $15.20 IL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) Gold Kidney OF Arizona T1 No $17.00 AZ
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) Elderplan, Inc. T1 No $22.70 NY
VIVA Medicare Extra Value (HMO D-SNP) Viva Health, Inc. T1 No $27.70 AL
VIVA Medicare Extra Care (HMO D-SNP) Viva Health, Inc. T1 No $27.70 AL
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 No $32.70 PA
Provider Partners Pennsylvania Essential Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 No $32.70 PA
Hamaspik Medicare Select (HMO D-SNP) Hamaspik, Inc. T1 No $34.50 NY
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 No $36.20 NC
Provider Partners North Carolina Essential Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 No $36.20 NC
Provider Partners Indiana Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Indiana T1 No $38.40 IN
Provider Partners Indiana Essential Plan (HMO I-SNP) Provider Partners Health Plan OF Indiana T1 No $38.40 IN
Provider Partners Kentucky Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Kentucky T1 No $38.40 KY

Showing top 50 of 100 plans.

Frequently Asked Questions

Is benzoyl peroxide 0.05 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel covered by Medicare Part D?

Yes, benzoyl peroxide 0.05 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel is covered by 2,726 Medicare Part D plans (54% of all Part D formularies).

What tier is benzoyl peroxide 0.05 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel on Medicare Part D plans?

benzoyl peroxide 0.05 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 0.05 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel require prior authorization?

0% of Part D formularies require prior authorization for benzoyl peroxide 0.05 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel. Step therapy: 0%. Quantity limits: 50.8%.

How much does Medicare spend on benzoyl peroxide 0.05 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel?

In 2023, total Medicare Part D spending on benzoyl peroxide 0.05 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