Losartan-Hctz

100-12.5 Mg — Tablet

Also known as: Hyzaar Losartan-Hctz 50-12.5 Mg Tablet Losartan-Hctz 100-12.5 Mg Tablet Losartan-Hctz 100-25 Mg Tablet

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

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 3 hours, 19 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026 via Hyzaar	Tier 3 - Non-Preferred Brand	—	—	—	None

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 3 hours, 19 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Home with UNC Health Alliance 2026 via Hyzaar	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Local 2026 via Hyzaar	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026 via Hyzaar	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026 via Hyzaar	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026 via Hyzaar	Tier 1 - Lowest Cost Generic	—	—	—	None

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 3 hours, 18 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026	Tier 1 - Generic	—	—	—	None

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 3 hours, 18 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Preferred	—	—	—	None
NC Medicaid Preferred Drug List 2026 via Hyzaar	Non-Preferred	—	—	—	None

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 3 hours, 18 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 via Hyzaar	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Hyzaar	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Hyzaar	Not Covered	—	—	—	None