Micardis HCT

Generic: Telmisartan-Hctz

25MG — Tablet

Also known as: MICARDIS HCT TAB 40/12.5 MICARDIS HCT TAB 80-25MG MICARDIS HCT TAB 80/12.5

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: 22 hours, 17 minutes ago

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

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 22 hours, 17 minutes ago

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

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 22 hours, 17 minutes ago

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

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 22 hours, 17 minutes ago

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

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 22 hours, 17 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026 via Telmisartan-Hctz	Unknown	—	—	✓	QL