Cetirizine

Generic: Zerviate

Tablet

Histamine-1 Receptor Antagonist

Also known as: Cetirizine 1 Mg/Ml Oral Solution Cetirizine 1 Mg/Ml Syrup
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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: 6 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Elite Bronze with Atrium Health
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Focused Silver with Atrium Health
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Complete Gold with Atrium Health
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Expanded Bronze with Atrium Health
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Silver with Atrium Health
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Gold with Atrium Health
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Complete Gold + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Everyday Bronze + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Elite Bronze + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Focused Silver with Atrium Health + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Complete Gold with Atrium Health + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Expanded Bronze + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Silver + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Gold + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Silver with Atrium Health + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Gold with Atrium Health + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver $0 Rx Options
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Everyday Bronze
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Elite Bronze
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Clear Silver with $0 Insulin Options
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Expanded Bronze
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Complete Gold
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Silver
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Signature Gold
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Streamlined Silver
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Enhanced CHF Heart Care Silver $0 Rx Options
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Streamlined Silver with Atrium Health
via Zerviate 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 6 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026
via Zerviate 		Tier 3 - Non-Preferred Brand — — — None
BCBS Federal Basic Option 2026
via Zerviate 		Tier 3 - Non-Preferred Brand — — — None
Source: CMS QHP JSON  ·  Formulary date: Sep 16, 2026  ·  Checked: 6 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
DEVOTED CHOICE GIVEBACK 009 NC (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED CHOICE GIVEBACK 006 NC (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (HMO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Dual (HMO D-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (HMO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Value Plus (HMO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Prime (HMO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature Care (HMO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Full Dual Care (HMO D-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Chronic Care (HMO C-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Enhanced (HMO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Chronic Care Value (HMO C-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED CORE 001 NC (HMO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED GIVEBACK 002 NC (HMO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED DUAL 009 NC (HMO D-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED GIVEBACK 012 NC (HMO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED DUAL FULL 013 NC (HMO D-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Enhanced (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Enhanced (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature Extra (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature Giveback (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Aetna Medicare Signature (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED CHOICE 001 NC (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED CHOICE GIVEBACK 002 NC (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED CHOICE 003 NC (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED CHOICE GIVEBACK 004 NC (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED CHOICE 005 NC (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
DEVOTED CHOICE 008 NC (PPO)
via Zerviate 		Tier 4 - Non-Preferred — — — None
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 6 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via Zerviate 		Non-Preferred — — — None
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