Amoxicillin Medicare Coverage

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.

How much does Amoxicillin cost with Medicare?

Amoxicillin coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.

Contact your plan carrier or consult your plan formulary for more cost information.

Does Medicare cover Amoxicillin?

According to GoodRx, 99% of Medicare Advantage plans and Medicare Part D plans covered Amoxicillin in 2023.¹

• Medicare Advantage plans or Part D plans that cover Amoxicillin include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug coverage kicks in.
  
  
• Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). 89% of 2023 Medicare Advantage plans included prescription drug coverage.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. We represent carriers such as Humana, UnitedHealthcare^®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

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.

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.