Medicare Part D coverage · levothyroxine sodium · RxCUI 892255
levothyroxine sodium 0.3 MG Oral Tablet
Per the CMS 2026 Part D formulary file, levothyroxine sodium 0.3 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 1.1, with prior authorization required on 0% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T1.1
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for levothyroxine sodium 0.3 MG Oral Tablet
Per the CMS 2026 Part D formulary file, levothyroxine sodium 0.3 MG Oral Tablet (RxNorm concept RXCUI 892255, generic name levothyroxine sodium) appears on 328 distinct formulary files spanning 5,052 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 1.1.
Real-world access to levothyroxine sodium 0.3 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 8,687,969 Part D beneficiaries filled levothyroxine sodium 0.3 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $653,580,460 and an average per-beneficiary annual cost of $75.23. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry levothyroxine sodium 0.3 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 1, Preferred Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 8,687,969
- Total spending
- $653,580,460
- Avg per beneficiary
- $75.23
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering levothyroxine sodium 0.3 MG Oral Tablet
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T1 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T1 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T1 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T1 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T1 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering levothyroxine sodium 0.3 MG Oral Tablet
95 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T1 | No | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-S1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-V1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete AZ-S001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete VA-Y4 (PPO D-SNP) | Care Improvement Plus South Central Insurance Co. | T1 | No | $0 | VA |
| AARP Medicare Advantage from UHC AL-0001 (HMO-POS) | Unitedhealthcare OF THE Midlands, Inc. | T1 | No | $0 | AL |
| AARP Medicare Advantage from UHC CA-0002 (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| UHC Sharp Medicare Advantage CA-001P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| AARP Medicare Advantage from UHC CA-003P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
Show the next 30 plans
Showing top 50 of 95 plans.
Frequently Asked Questions
Is levothyroxine sodium 0.3 MG Oral Tablet covered by Medicare Part D?
Yes, levothyroxine sodium 0.3 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is levothyroxine sodium 0.3 MG Oral Tablet on Medicare Part D plans?
levothyroxine sodium 0.3 MG Oral Tablet averages Tier 1.1 across Part D plans, ranging from Tier 1 to Tier 6.
Does levothyroxine sodium 0.3 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for levothyroxine sodium 0.3 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on levothyroxine sodium 0.3 MG Oral Tablet?
In 2023, total Medicare Part D spending on levothyroxine sodium 0.3 MG Oral Tablet was $653,580,460, covering 8,687,969 beneficiaries. The average spend per beneficiary was $75.23.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
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