olmesartan-hydrochlorothiazide
20-12.5 MG, 40 MG-25MG, 40-12.5 MG — Tablet
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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.
TRICARE
1 plan| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| TRICARE Uniform Formulary 2026 | Tier 1 - Generic Formulary | ✓ | ✓ | — | PA | ST PA: TPA - ALDACTONE TABLET FOR MALE PTS 11 THRU 18 YRS OF AGE W/O QUALIFIERS IN 360 DAYS REQ PA; Step therapy: 1270/99001/125825 ST RAA RX<1/180, DOD PA REQUIRED |