Does Gold 22 Health cover hydroxyzine?
Gold 22 Health
13887-13887FL0010001-0 · ACA · ACA Marketplace
hydroxyzine
hydroxyzineunder Gold 22 Health
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
$15per 30-day fill
From the first fill — no deductible on this drug.
This is the standard amount. If you qualified for a cost-sharing reduction when you enrolled, set your level above and this will follow it.
- Tier
- Generics
- Approval first
- Not needed
- Try another first
- No
- Amount limit
- None
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 14, 2026 · CMS QHP machine-readable. Reference information, not medical advice and not a price.
Covered forms and strengths (9)
- hydroxyzine hydrochloride 10 MG Oral Tablet
- hydroxyzine hydrochloride 2 MG/ML Oral Solution
- hydroxyzine hydrochloride 25 MG Oral Tablet
- hydroxyzine hydrochloride 50 MG Oral Tablet
- hydroxyzine pamoate 100 MG Oral Capsule
- hydroxyzine pamoate 25 MG Oral Capsule
- hydroxyzine pamoate 25 MG Oral Capsule [Vistaril]
- hydroxyzine pamoate 50 MG Oral Capsule
- hydroxyzine pamoate 50 MG Oral Capsule [Vistaril]