Aller-Tec

Generic: cetirizine hydrochloride

10 MG — Tablet

Histamine-1 Receptor Antagonist

Also known as: cetirizine hydrochloride
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Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Formulary date: Jan 1, 2026  ·  Checked: 13 hours, 28 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Complete Gold
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze with Atrium Health
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver with Atrium Health
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold with Atrium Health
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver with Atrium Health + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold with Atrium Health + Vision + Adult Dental
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze Tier 1 - Preferred Generic — — ✓ QL
Standard Gold Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Standard Silver with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Standard Gold with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Complete Gold + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Standard Silver + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health
via Wal-Zyr 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze Tier 1 - Preferred Generic — — ✓ QL
Standard Gold + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Standard Silver with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Standard Gold with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Standard Expanded Bronze with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Silver with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Standard Gold with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Clear Silver with $0 Insulin Options
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Expanded Bronze
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Silver with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Gold with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Silver with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Gold with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Complete Gold + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Focused Silver with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Complete Gold with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Expanded Bronze + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Silver + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Gold + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Silver
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Gold
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Focused Silver with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Complete Gold with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Standard Expanded Bronze with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
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