Does KP OR Silver 4000 cover levothyroxine?
KP OR Silver 4000
71287-71287OR0420012-0 · ACA · ACA Marketplace
levothyroxine
levothyroxineunder KP OR Silver 4000
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
$25per 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.
Amount limit applies — you can still fill it, but your plan caps how much you get at a time. This plan's drug list records the cap without stating the amount — your pharmacy can tell you when they fill it.
- Tier
- Generic
- Approval first
- Not needed
- Try another first
- No
- Amount limit
- Yes
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 (13)
- levothyroxine sodium 0.02 MG/ML Oral Solution [Thyquidity]
- levothyroxine sodium 0.025 MG Oral TabletAmount limit
- levothyroxine sodium 0.05 MG Oral TabletAmount limit
- levothyroxine sodium 0.075 MG Oral TabletAmount limit
- levothyroxine sodium 0.088 MG Oral TabletAmount limit
- levothyroxine sodium 0.1 MG Oral TabletAmount limit
- levothyroxine sodium 0.112 MG Oral TabletAmount limit
- levothyroxine sodium 0.125 MG Oral TabletAmount limit
- levothyroxine sodium 0.137 MG Oral TabletAmount limit
- levothyroxine sodium 0.15 MG Oral TabletAmount limit
- levothyroxine sodium 0.175 MG Oral TabletAmount limit
- levothyroxine sodium 0.2 MG Oral TabletAmount limit
- levothyroxine sodium 0.3 MG Oral TabletAmount limit