lisinopril/hydrochlorothiazide

10 mg-12.5 mg, 20 mg-12.5 mg, 20 mg-25 mg — Tablet

Also known as: ZESTORETIC LISINOPRIL-HYDROCHLOROTHIAZIDE

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 1 hour, 56 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 1 - Basic Core Formulary	✓	—	—	PA

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 1 hour, 56 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026 via lisinopril-hydrochlorothiazide	Tier 1 - $0 Copay Preventive	—	—	✓	QL