Augmentin (Amoxicillin/Clavulanate) Medicare Coverage

Augmentin
Chemical name: Amoxicillin/Clavulanate

Brand name: Augmentin

Typical dosage: 875mg/125mg

Typical type: Tablet1

Augmentin is an antibiotic medication used to treat different types of infections. It is available as a brand name drug or as a generic and is available as an oral tablet or liquid.

Augmentin is an antibiotic medication that contains the active ingredients Amoxicillin and Clavulanate. It is used to manage infections, including nose and throat infections, bladder infections, respiratory infections and skin infections.

Augmentin prevents bacteria from creating a cell wall, which helps to stop the spread of infection. Augmentin dosing varies depending on what type of infection you are treating.

The most common side effects of Augmentin include upset stomach and diarrhea.

Does Medicare cover Augmentin or Amoxicillin/Clavulanate?

While some Medicare plans may not cover Augmentin, some Medicare Advantage plans and Medicare Part D plans may cover generic Amoxicillin/Clavulanate.

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.1

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Amoxicillin/Clavulanate.

Find Medicare Advantage plans with drug coverage

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

 

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Average costs for Amoxicillin/Clavulanate with Medicare drug coverage

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in and the Medicare drug plan you have.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.

Additional information

Finish your entire course of Augmentin as your doctor instructs you to in order to completely heal your infection.

Augmentin can be taken with or without food, though taking it with food can help prevent an upset stomach. Try to not miss doses, and take this drug at roughly the same time of day.

Let your doctor know if you experience severe diarrhea while taking Augmentin, or if you experience signs of an allergic reaction like rash or swelling.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.