Medicare Part D coverage · levothyroxine sodium · RxCUI 966157
levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl]
Per the CMS 2026 Part D formulary file, levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl] is covered by 4,714 Medicare Part D plans (93.3% of enrollable products), averaging Tier 1.9, with prior authorization required on 0% of covering formularies.
- 93.3%
- Plan coverage
- 4,714
- Plans covering
- T1.9
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl]
Per the CMS 2026 Part D formulary file, levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl] (RxNorm concept RXCUI 966157, generic name levothyroxine sodium) appears on 268 distinct formulary files spanning 4,714 Medicare Part D plan offerings - 93.3% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.9.
Real-world access to levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl] 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 0.025 MG Oral Tablet [Levoxyl] 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 0.025 MG Oral Tablet [Levoxyl] today.
Coverage Details
- Formularies covering
- 268
- Plans covering
- 4,714
- Coverage rate
- 93.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, 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
Medicare Advantage Plans (MA-PD) Covering levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
Show the next 30 plans
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature (HMO) | Aetna Health Inc. (GA) | T1 | No | $0 | GA |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | No | $0 | WI |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | No | $0 | IL |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | Coventry Health Care OF Illinois, Inc. | T1 | No | $0 | IL |
| Aetna Medicare Signature Extra (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | No | $0 | IL |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | IA |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | NE |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS, MO |
| Aetna Medicare Signature Extra (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS, MO |
| Aetna Medicare Signature Plus (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | AR |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS |
| Aetna Medicare Advantra (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | OH |
| Aetna Medicare Advantra Signature Giveback (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | WV |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | IA |
| Aetna Medicare Signature Extra (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | NE |
| Aetna Medicare Advantra Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | WV |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | IL, MO |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | MO |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS, MO |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | AR |
| Aetna Medicare Dual (PPO D-SNP) | Coventry Health AND Life Insurance Company | T1 | No | $0 | SD |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | MO |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS |
| Aetna Medicare Dual Extra (PPO D-SNP) | Coventry Health AND Life Insurance Company | T1 | No | $0 | AR |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl] covered by Medicare Part D?
Yes, levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl] is covered by 4,714 Medicare Part D plans (93.3% of all Part D formularies).
What tier is levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl] on Medicare Part D plans?
levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl] averages Tier 1.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl] require prior authorization?
0% of Part D formularies require prior authorization for levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl]?
In 2023, total Medicare Part D spending on levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl] 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
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