LEVOTHYROXINE SODIUM 75 ug Tablet
Coverage in Alabama and Tennessee (CMS PDP Region 12).
12 of 12 stand-alone Part D plans in Alabama and Tennessee cover this drug on tier 1–2.
Lowest 30-day cost $0.00 at a preferred pharmacy. No plan applies a prior authorization, step therapy or quantity limit.
211 Medicare Advantage plans in AL, TN do cover it
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. AL: 89 plans · TN: 122 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1678 | — | None |
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0579 | — | None |
| Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1733 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1977 | — | None |
| BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $4.00 | $0.1260 | — | None |
| HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2139 | — | None |
| SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2051 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1678 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.2630 | — | None |
| BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1260 | — | None |
| Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2264 | — | None |
| HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.0836 | — | None |
Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.