clindamycin phos/skin clnsr 19

1 % — Kit

ACNE AGENTS

Also known as: CLINDACIN PAC CLINDACIN ETZ

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Nov 5, 2026  ·  Checked: 5 hours, 30 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Bronze 7000 HSA Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Bronze 6500 Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Bronze 5500 Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Silver 5000 Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Silver 3600 Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Silver 3000 Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Bronze CMS Standard
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Silver CMS Standard
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Gold CMS Standard
via Clindacin Etz
Tier 2 - Generic — — — None
Connect myDiabetesCare Bronze
via Clindacin Etz
Tier 2 - Generic — — — None
Connect myDiabetesCare Silver
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Gold 1500 Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Bronze RD 5000 Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Bronze RD 6000 Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Bronze RD CMS Standard
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Silver RD 3500 Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Silver RD 5000 Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Silver RD CMS Standard
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Silver RD 2200 Indiv Med Deductible
via Clindacin Etz
Tier 2 - Generic — — — None
Connect Gold RD CMS Standard
via Clindacin Etz
Tier 2 - Generic — — — None
Source: Excel (XLSX)  ·  Formulary date: Oct 29, 2026  ·  Checked: 5 hours, 30 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via Clindacin Etz
Tier 1 - Generic Formulary — ✓ — ST Step therapy on 1 of 2 NDCs: CLINDAGEL,CLINDACIN ETZ/PAC,NEUAC,ONEXTON, WO 3 DIFF GEN ACNE DRUGS IN LAST 180D REQ PA
TRICARE Uniform Formulary 2026
via Clindacin Pac
Tier 3 - Non-Formulary — ✓ — ST Step therapy: CLINDAGEL,CLINDACIN ETZ/PAC,NEUAC,ONEXTON, WO 3 DIFF GEN ACNE DRUGS IN LAST 180D REQ PA
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