Amoxicillin Medicare Coverage

Amoxicillin
Chemical name: Amoxicillin

Brand name: Amoxil

Typical dosage: 500

Typical type: Capsule1

Amoxicillin is an antibiotic medication used to treat a variety of infections. It is available as a brand name drug or generic, and it’s available as an oral capsule, tablet or liquid.

Amoxicillin is an antibiotic medication commonly used for the treatment of infections such as ear, nose, and throat infections, bladder infections, respiratory infections and skin infections.

Amoxicillin dosing varies depending on what type of infection you are treating. Amoxicillin blocks bacteria from growing to allow the infection to heal.

The most common side effects of amoxicillin include upset stomach, diarrhea and headache.

Does Medicare cover Amoxicillin or Amoxil?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Amoxicillin.1

  • 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.2

  • 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.

Find Medicare Advantage plans with drug coverage

Compare Plans

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

Average costs for Amoxicillin with Medicare drug coverage1

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

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.
$1 – $10 Free – $10

Additional information

It is very important to take your full course of Amoxicillin antibiotics, even if you start to feel better. Stopping your antibiotics early can cause your infection to return and get worse.

Amoxicillin can be taken with or without food. If you get a stomach ache after taking this medication, taking it with food can help prevent this side effect. If you take the liquid form, shake well before use and measure the liquid dose carefully.

Try to not miss doses, and try to take this drug at roughly the same time of day.

Talk to your doctor if you have any severe side effects, especially if you experience extreme diarrhea, as it may be indicative of a more serious condition.

People often have allergic reactions to antibiotics. Tell your doctor if you experience signs of an allergic reaction including rash, itchiness, hives, wheezing, tightness in the chest or throat, trouble breathing, or swelling of the mouth, face, lips, tongue or throat.

 

 

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.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 GoodRx. Amoxicillin. Retrieved May 2019, from www.goodrx.com/amoxicillin.

2 Jacobson, Gretchen; et al. A Dozen Facts About Medicare Advantage. (Nov. 13, 2018). Kaiser Family Foundation. Retrieved from www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.