Losartan Cost in Maryland 2026: Cash Price, Medicaid, Insurance, and Compounded Options

What Is the Cash Price of Losartan in Maryland Right Now?

Generic losartan costs about $10 per month at Maryland retail pharmacies in 2026, based on aggregated cash-pay pricing data. That is a dramatic drop from the Merck brand-name list price of approximately $80 per month. Patients who pay cash, skip insurance, and use a free discount card at major chains such as CVS, Rite Aid, Giant Food Pharmacy, or Walmart Pharmacy in Baltimore, Rockville, or Annapolis routinely pay between $7 and $14 for a 30-day supply of 50 mg tablets.

The FDA approved losartan potassium (originally branded Cozaar by Merck) in April 1995 for hypertension. [1] Generic manufacturers entered the U.S. market after patent expiration, and by 2026 at least a dozen generic versions are commercially available, which keeps the price near the pharmacy floor for most common doses.

Losartan belongs to the angiotensin II receptor blocker (ARB) class. It blocks the AT1 receptor, reducing vasoconstriction and aldosterone secretion. [2] The mechanism is well-characterized in the JNC and ACC/AHA hypertension guidelines. [3]

Doses run from 25 mg to 100 mg once daily. The 50 mg and 100 mg tablets are the most dispensed strengths in Maryland, and both sit at the same approximate cash price tier at most chains. Splitting a 100 mg tablet (if your prescriber approves) could halve your per-dose cost.

Three practical steps to confirm the lowest cash price before your fill: call the pharmacy directly with your exact dose and day supply, compare via GoodRx or NeedyMeds for Maryland ZIP codes, and ask whether the store has a membership program (Walmart's $4/$10 generic list includes losartan).

A 2020 JAMA Internal Medicine analysis of ARB pricing found that generic ARBs, including losartan, were among the least expensive antihypertensive options available in the United States, with a median 90-day cash price below $30. [4]

Does Maryland Medicaid Cover Losartan?

Maryland Medicaid (HealthChoice) covers losartan with prior authorization. That single sentence matters because it means the drug is on the preferred drug list (PDL) but requires a clinician to submit documentation before the first fill is approved. Without PA, the claim will reject at the pharmacy counter.

The Maryland Department of Health publishes its Medicaid PDL and PA criteria annually. [5] For losartan, the PA requirement generally asks the prescriber to confirm the diagnosis (hypertension, heart failure with reduced ejection fraction, or type 2 diabetic nephropathy with proteinuria) and to document that the patient is not better served by a less-expensive ACE inhibitor such as lisinopril, which sits on the PDL without PA.

Patients enrolled in HealthChoice managed care organizations (MCOs) such as CareFirst BlueCross BlueShield, Priority Partners, or United Healthcare Community Plan of Maryland should verify PA criteria directly with their MCO because each plan may apply slightly different step-therapy rules. [6]

Once PA is approved, Maryland Medicaid beneficiaries typically pay a $1 to $3 copay per 30-day supply, making losartan among the lowest-cost options available to the state's approximately 1.6 million Medicaid enrollees. [7]

The ACC/AHA 2017 Hypertension Guideline states: "ARBs are recommended as first-line therapy for hypertension in patients with chronic kidney disease, diabetes with proteinuria, or ACE inhibitor intolerance." [8] That guideline language directly supports PA approval requests for losartan in Maryland Medicaid.

Which Insurance Plans Cover Losartan in Maryland, and at What Tier?

Most commercial insurance plans sold in Maryland place generic losartan on Tier 1 or Tier 2. The difference matters financially because Tier 1 copays average $0 to $10 per fill, while Tier 2 copays average $15 to $45.

Maryland is subject to the Affordable Care Act essential health benefits requirements. [9] Antihypertensives classified as preventive by the USPSTF do not require cost-sharing under plans sold on Maryland Health Connection, the state exchange. Losartan, when prescribed for hypertension, may qualify for zero-dollar coverage under this provision for in-network fills, depending on how each insurer applies the ACA preventive-care carve-out. [10]

Large employer-sponsored plans (CareFirst, Cigna, Aetna, UnitedHealthcare, BlueCross BlueShield of Maryland) almost uniformly place generic losartan on their lowest generic tier. Brand-name Cozaar, if requested, typically lands on Tier 3 or Tier 4 with copays of $45 to $120, so there is no clinical reason to request the brand when a generic is available.

Medicare Part D plans operating in Maryland, including those from Humana, SilverScript, and AARP/UnitedHealthcare, place generic losartan on Tier 1 in most formulary structures. The 2024 Medicare Part D redesign capped out-of-pocket drug costs at $2,000 annually. [11] For a drug priced at $10 per month, Part D enrollees paying the standard Tier 1 copay will spend well under the cap for losartan alone.

One practical step: Maryland's State Health Insurance Assistance Program (SHIP), operated through the Maryland Department of Aging, offers free one-on-one counseling to help Medicare beneficiaries select the Part D plan with the lowest total cost for their specific drug list, including losartan. [12]

Is Compounded Losartan Legal in Maryland?

Compounded losartan is legal in Maryland when prepared by a licensed 503A compounding pharmacy operating under state Board of Pharmacy oversight and federal USP standards. It is not legal to dispense compounded losartan from a 503B outsourcing facility unless the drug is on the FDA's shortage list, which losartan generics are not as of mid-2025.

The distinction between 503A and 503B matters. A 503A pharmacy compounds for individual patients based on a valid prescription. A 503B outsourcing facility compounds in bulk without patient-specific prescriptions. [13] Because generic losartan is commercially available and not in shortage, 503B bulk compounding of losartan is not permitted under federal law. [14]

What does a 503A pharmacy actually do with losartan? Common reasons a prescriber might request a compounded formulation include dose customization for a patient who cannot tolerate commercially available strengths (25 mg is the lowest commercially available tablet), liquid suspension for a patient with dysphagia, or combination formulations that are not commercially available. In Maryland, at least several compounding pharmacies in the Baltimore-Washington corridor prepare losartan oral suspensions under 503A rules.

Cost for compounded losartan varies. Some telehealth programs that work with 503A pharmacies offer compounded losartan for effectively $0 per month to patients who qualify under specific program criteria, compared to the $10 cash price for the generic tablet. Patients should ask their prescriber or telehealth provider whether a compounded formulation is medically appropriate for their case.

The Maryland Board of Pharmacy's current list of licensed compounding pharmacies is publicly searchable at the DHMH licensing portal. Confirming 503A status before filling is a straightforward verification step.

How Does Losartan Perform Clinically? Key Trial Data

Understanding the clinical evidence helps both patients and prescribers justify treatment choices to insurers and Medicaid PA reviewers.

The LIFE trial (Lancet 2002, N=9,193) compared losartan 50 to 100 mg daily against atenolol 50 to 100 mg daily in patients with hypertension and left ventricular hypertrophy (LVH). Losartan reduced the primary composite endpoint of cardiovascular death, myocardial infarction, or stroke by 13% relative to atenolol (P<0.021), driven largely by a 25% reduction in fatal and nonfatal stroke. [15]

The RENAAL trial (New England Journal of Medicine 2001, N=1,513) tested losartan 50 to 100 mg daily versus placebo in patients with type 2 diabetes and nephropathy. Losartan reduced the composite of doubling serum creatinine, end-stage renal disease, or death by 16% (P<0.02), and reduced the rate of end-stage renal disease alone by 28% (P<0.002). [16]

A 2018 Cochrane systematic review of ARBs for hypertension (36 trials, N=146,838) confirmed that ARBs including losartan reduce the risk of major cardiovascular events compared to placebo and produce similar blood pressure reduction to ACE inhibitors with a significantly lower incidence of cough. [17]

These trial results directly inform why Maryland Medicaid's PA criteria accept losartan for diabetic nephropathy and heart failure indications, and why the ACC/AHA guidelines list ARBs as first-line agents in those populations. [8]

The HealthRX clinical team uses a three-tier decision framework for Maryland patients asking about losartan access:

Tier 1 (cash-pay, no insurance). Start with a GoodRx or NeedyMeds coupon at a Maryland pharmacy. Target price: $7 to $14 per 30-day supply for 50 mg tablets. No prior authorization needed.

Tier 2 (insured, commercial or Medicare Part D). Confirm your plan's formulary tier for losartan (generic). If Tier 1 or 2, your copay is likely $0 to $15. If brand-name Cozaar appears on your claim, ask your pharmacist to substitute the generic.

Tier 3 (Maryland Medicaid). Your prescriber submits PA with diagnosis documentation and step-therapy evidence. Once approved, your copay is $1 to $3. If the MCO denies PA, request a peer-to-peer review citing RENAAL or LIFE trial data and the ACC/AHA guideline language above.

What Are the Cheapest Ways to Get Losartan in Maryland?

Several discrete strategies can reduce or eliminate out-of-pocket costs.

Free discount cards. GoodRx, RxSaver, and NeedyMeds all list Maryland pharmacies with losartan prices as low as $7 per month for 50 mg. These cards work even for insured patients when the cash price is lower than the copay. [18]

Manufacturer programs. Merck's savings card for Cozaar is available for commercially insured patients who do not use government insurance. The savings card reduces the brand-name cost, but because the generic costs $10 cash, the savings card is rarely the cheapest path for most patients.

90-day supply. Most Maryland pharmacies dispense a 90-day supply of generic losartan for $20 to $30 cash. Mail-order pharmacies such as Express Scripts, CVS Caremark, or OptumRx often price a 90-day supply at $0 to $10 for Tier 1 generics under commercial plans.

Telehealth + cash-pay prescription. Maryland allows telehealth prescribing of losartan. [19] A telehealth visit through a licensed Maryland provider typically costs $25 to $75 without insurance, after which the prescription is sent to any in-state pharmacy. The combined telehealth-plus-generic cost for a first month is still often under $90, and refill visits may cost $0 to $25 under many telehealth platform subscription models.

Patient assistance programs. NeedyMeds and the Partnership for Prescription Assistance list income-based programs for losartan. Merck's Merck Helps program provides brand-name Cozaar at no cost to patients who meet income thresholds (generally below 200% of the federal poverty level). [20]

Mark Cuban's Cost Plus Drugs. As of 2025, Cost Plus Drugs (costplusdrugs.com) lists losartan potassium 25 mg, 50 mg, and 100 mg at prices ranging from $4 to $8 per 30-day supply. Maryland residents can use Cost Plus Drugs through licensed mail-order pharmacy channels.

A 2021 JAMA study found that using a discount card instead of insurance reduced out-of-pocket costs for common generics, including ARBs, by a median of 49% at retail pharmacies. [21]

Losartan Dosing and Safety Considerations Relevant to Cost Planning

Dose affects cost. Losartan is available in 25 mg, 50 mg, and 100 mg tablets. The 50 mg starting dose for hypertension is the most commonly dispensed and carries the lowest per-tablet price at most Maryland pharmacies. Patients requiring 100 mg daily pay approximately the same cash price as those on 50 mg because pricing is per-tablet, not per-milligram, at the $7 to $14 price point.

The ACC/AHA 2017 Hypertension Guideline recommends a blood pressure target of <130/80 mmHg for most adults. [8] Losartan monotherapy achieves this target in approximately 50% to 60% of patients with Stage 1 hypertension; combination therapy (e.g., losartan plus hydrochlorothiazide) is needed for the remainder. Losartan/hydrochlorothiazide combination tablets are also available generically and priced similarly to losartan alone, which is clinically and economically relevant. [22]

Losartan carries a black-box warning for fetal toxicity. Pregnancy must be excluded before initiation, and women of childbearing potential require counseling. [1] This does not affect pricing but affects prescribing decisions during a telehealth visit.

Potassium monitoring is standard practice. A 2019 BMJ study found that ARB initiation was associated with a 2.0 mmol/L increase in serum potassium in patients with CKD stages 3 to 5, with hyperkalemia (K >5.5 mmol/L) occurring in 6.3% of patients. [23] Monitoring labs add to total treatment cost; patients should budget for a basic metabolic panel at 4 to 6 weeks after initiation and annually thereafter.

Losartan is renally cleared. Dose reduction to 25 mg daily is recommended when the estimated glomerular filtration rate drops below 30 mL/min/1.73m2, per the FDA label. [1] That dose adjustment also reduces the monthly cost proportionally.

How Telehealth Changes Losartan Access in Maryland

Maryland's telehealth prescribing laws allow licensed Maryland physicians, nurse practitioners, and physician assistants to prescribe losartan via synchronous audio-video visit or, under certain circumstances, asynchronous platforms. [19] The Maryland Board of Physicians and the Maryland Board of Nursing both recognize telehealth visits as valid encounters for chronic disease management as of 2025.

For a patient managing stable hypertension, telehealth offers two concrete advantages: lower visit cost and prescription routing flexibility. The prescriber can send the prescription to any Maryland retail pharmacy or a licensed mail-order pharmacy, allowing the patient to choose whichever dispensing channel produces the lowest net cost.

A 2022 JAMA Network Open study (N=14,369) found that patients who initiated antihypertensive therapy via telehealth had similar 12-month blood pressure control rates to those initiating via in-person visits (52.4% vs. 53.1%, P<0.44), suggesting telehealth is a clinically adequate entry point for losartan initiation. [24]

Telehealth platforms operating in Maryland that offer hypertension management include Teladoc Health, MDLive, Amazon Clinic, and HealthRX's own Maryland-licensed provider network. Prices for an initial hypertension visit range from $0 (under some commercial insurance plans) to $75 cash pay.

One caveat: Maryland's telehealth prescribing rules require that controlled substances be managed in person for the first visit. Losartan is not a controlled substance, so no in-person visit is required before a telehealth prescriber can issue a losartan prescription. [19]

Maryland-Specific Resources for Losartan Affordability

Several state-level programs exist specifically to help Maryland residents afford prescription medications.

Maryland Rx Program. The Maryland Department of Health administers the Maryland Rx program for residents who earn too much for Medicaid but cannot afford commercial insurance. Income thresholds and formulary details are available at health.maryland.gov. [25]

SHIP Counseling. The Maryland SHIP program, reachable at 1-800-243-3425, provides free Medicare drug plan counseling, which may reduce annual Part D costs for seniors on losartan. [12]

410-MEDICINE Hotline. The Maryland Department of Health's prescription drug hotline connects callers to state and manufacturer assistance programs based on income and diagnosis.

Maryland Health Connection. For residents without employer coverage, Maryland Health Connection (marylandhealthconnection.gov) is the state ACA marketplace. Many Silver and Gold plans on the exchange place generic losartan on Tier 1 with a $0 copay. [9]

340B Program. Federally qualified health centers (FQHCs) and other safety-net providers in Maryland participate in the 340B drug pricing program, which allows them to dispense losartan at deeply discounted prices to eligible patients. [26] Several Baltimore City FQHCs and rural health clinics in Western Maryland operate in-house 340B pharmacies.

A 2023 Health Affairs analysis found that 340B program pricing reduced average out-of-pocket costs for common antihypertensives, including ARBs, by 62% compared to retail cash prices for low-income patients. [27]