Chlorhexidine (Periogard/Peridex) Medicare Coverage

Chlorhexidine
Chemical name: Chlorhexidine

Brand name: Peridex, Periogard

Typical dosage: 472ml of 0.12%

Typical type: Oral liquid1

Chlorhexidine is a medication used to treat a variety of conditions of the mouth, such as gingivitis. Chlorhexidine is available as a brand name or as a generic and comes as an oral liquid.

Chlorhexidine is a medication used to treat or prevent infections of the mouth including gingivitis and periodontitis. It can also be used prior to surgery to prevent infections from ventilator tubing. The brand name equivalents of Chlorhexidine include Periogard and Peridex.

Chlorhexidine is typically used twice daily. Chlorhexidine helps kill bacteria and prevent new bacteria from forming.

Chlorhexidine is typically well tolerated, but side effects may include mouth irritation or a bad taste in your mouth.

Does Medicare cover Chlorhexidine or Periogard?

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

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Average costs for Chlorhexidine 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 – $9 Free – $9

Additional information

For proper use of Chlorhexidine, first brush and floss your teeth.

Rinse your mouth with 1 tablespoon of Chlorhexidine and swish it in your mouth for about 30 seconds. Spit the liquid out. Do not swallow this drug. Rinse twice a day unless your doctor tells you otherwise, in the morning and in the evening.

Wait 30 minutes before eating, drinking, using mouthwash or brushing your teeth after using Chlorhexidine.

Tell your doctor if you experience any numbness or tingling in your mouth, extreme gum pain or gum 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.

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

1 GoodRx. Chlorhexidine. Retrieved Sep. 2019, from www.goodrx.com/chlorhexidine.

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.