Wal-Zyr

Generic: cetirizine hydrochloride

10 MG — Tablet

Histamine-1 Receptor Antagonist

Also known as: cetirizine hydrochloride
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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: 21 hours, 46 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Complete Gold
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver $0 Rx Options
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold with Atrium Health + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced CHF Heart Care Silver $0 Rx Options
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Streamlined Silver with Atrium Health
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Streamlined Silver
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via cetirizine hydrochloride 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver $0 Rx Options
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold with Atrium Health + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced CHF Heart Care Silver $0 Rx Options
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Streamlined Silver with Atrium Health
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Streamlined Silver
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via Zyrtec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver $0 Rx Options Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze Tier 1 - Preferred Generic — — ✓ QL
Signature Silver Tier 1 - Preferred Generic — — ✓ QL
Signature Gold Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Signature Silver with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Signature Gold with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Complete Gold + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Signature Silver + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Signature Gold + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Signature Silver with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Signature Gold with Atrium Health + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Enhanced CHF Heart Care Silver $0 Rx Options Tier 1 - Preferred Generic — — ✓ QL
Streamlined Silver with Atrium Health Tier 1 - Preferred Generic — — ✓ QL
Streamlined Silver Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental Tier 1 - Preferred Generic — — ✓ QL
Complete Gold
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver $0 Rx Options
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze with Atrium Health
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver with Atrium Health
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold with Atrium Health
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Silver with Atrium Health + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Signature Gold with Atrium Health + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced CHF Heart Care Silver $0 Rx Options
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Streamlined Silver with Atrium Health
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Streamlined Silver
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via Aller-Tec 		Tier 1 - Preferred Generic — — ✓ QL
Complete Gold
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Enhanced Asthma/COPD Care Silver $0 Rx Options
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Clear Silver with $0 Insulin Options
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Silver
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Gold
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Focused Silver with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Complete Gold with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Silver with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Gold with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Complete Gold + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Elite Bronze with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Focused Silver with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Complete Gold with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Silver + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Gold + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Silver with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Signature Gold with Atrium Health + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Enhanced CHF Heart Care Silver $0 Rx Options
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Streamlined Silver with Atrium Health
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Streamlined Silver
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Clear Silver with $0 Insulin Options + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental
via Quzyttir 		Tier 4 - Non-Preferred ✓ — — PA
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