Amoxicillin-Clavulanate (Augmentin) Medicare Coverage

Amoxicillin-Clavulanate
Chemical name: Amoxicillin/Potassium Clavulanate

Brand name: Augmentin

Typical dosage: 875mg/126mg

Typical type: Tablet1

Amoxicillin-clavulanate is an antibiotic medication used to treat a variety of infections. It is available as a brand name drug or as a generic and is available as an oral tablet or liquid.

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

Amoxicillin-clavulanate dosing varies depending on what type of infection you are treating. Its brand name equivalent is Augmentin.

Amoxicillin-clavulanate blocks bacteria from growing to allow the infection to heal. The most common side effects of amoxicillin-clavulanate include upset stomach and diarrhea.

Does Medicare cover Amoxicillin-clavulanate or Augmentin?

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

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Average costs for Amoxicillin-clavulanate 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.
$2 – $22 Free – $20

Additional information

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

Amoxicillin-clavulanate can be taken with or without food, but taking it with food may help reduce your risk of developing an upset stomach.

Talk to your doctor if you have any severe side effects. Especially if you experience severe 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, tightness in the chest or throat 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.