FillMapMHP Gold

Does MHP Gold cover levothyroxine?

MHP Gold
74917-74917MI0020006-0 · ACA · ACA Marketplace
levothyroxine
levothyroxineunder MHP Gold
Covered — the conditions depend on which form
Not the same for every form: 5 of 78 need your plan’s approval first, and 50 of 78 usually need a preferred medication tried first. Check your exact form in the list below — your doctor’s office handles either.
What you'd pay

This plan doesn't publish a price for this tier. Your pharmacy can quote it before you fill.

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
Non preferred
Approval first
Required
Try another first
Required
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 (78)

  • levothyroxine sodium 0.02 MG/ML Oral Solution [Thyquidity]Approval firstAmount limit
  • levothyroxine sodium 0.025 MG Oral Tablet
  • levothyroxine sodium 0.025 MG Oral Tablet [Euthyrox]
  • levothyroxine sodium 0.025 MG Oral Tablet [Levo-T]Try another first
  • levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl]Try another first
  • levothyroxine sodium 0.025 MG Oral Tablet [Synthroid]Try another first
  • levothyroxine sodium 0.025 MG Oral Tablet [Unithroid]Try another first
  • levothyroxine sodium 0.03 MG/ML Oral Solution [Ermeza]Approval first
  • levothyroxine sodium 0.0375 MG Oral Capsule [Tirosint]Try another firstAmount limit
  • levothyroxine sodium 0.0375 MG/ML Oral Solution [Tirosint]Approval first
  • levothyroxine sodium 0.044 MG Oral Capsule [Tirosint]Try another firstAmount limit
  • levothyroxine sodium 0.044 MG/ML Oral Solution [Tirosint]Approval first
  • levothyroxine sodium 0.05 MG Oral Tablet
  • levothyroxine sodium 0.05 MG Oral Tablet [Euthyrox]
  • levothyroxine sodium 0.05 MG Oral Tablet [Levo-T]Try another first
  • levothyroxine sodium 0.05 MG Oral Tablet [Levoxyl]Try another first
  • levothyroxine sodium 0.05 MG Oral Tablet [Synthroid]Try another first
  • levothyroxine sodium 0.05 MG Oral Tablet [Unithroid]Try another first
  • levothyroxine sodium 0.0625 MG Oral Capsule [Tirosint]Try another firstAmount limit
  • levothyroxine sodium 0.0625 MG/ML Oral Solution [Tirosint]Approval first
  • levothyroxine sodium 0.075 MG Oral Tablet
  • levothyroxine sodium 0.075 MG Oral Tablet [Euthyrox]
  • levothyroxine sodium 0.075 MG Oral Tablet [Levo-T]Try another first
  • levothyroxine sodium 0.075 MG Oral Tablet [Levoxyl]Try another first
  • levothyroxine sodium 0.075 MG Oral Tablet [Synthroid]Try another first
  • levothyroxine sodium 0.075 MG Oral Tablet [Unithroid]Try another first
  • levothyroxine sodium 0.088 MG Oral Tablet
  • levothyroxine sodium 0.088 MG Oral Tablet [Euthyrox]
  • levothyroxine sodium 0.088 MG Oral Tablet [Levo-T]Try another first
  • levothyroxine sodium 0.088 MG Oral Tablet [Levoxyl]Try another first
  • levothyroxine sodium 0.088 MG Oral Tablet [Synthroid]Try another first
  • levothyroxine sodium 0.088 MG Oral Tablet [Unithroid]Try another first
  • levothyroxine sodium 0.1 MG Oral Tablet
  • levothyroxine sodium 0.1 MG Oral Tablet [Euthyrox]
  • levothyroxine sodium 0.1 MG Oral Tablet [Levo-T]Try another first
  • levothyroxine sodium 0.1 MG Oral Tablet [Levoxyl]Try another first
  • levothyroxine sodium 0.1 MG Oral Tablet [Synthroid]Try another first
  • levothyroxine sodium 0.1 MG Oral Tablet [Unithroid]Try another first
  • levothyroxine sodium 0.112 MG Oral Tablet
  • levothyroxine sodium 0.112 MG Oral Tablet [Euthyrox]

← All coverage for levothyroxine