FillMapValue Benchmark Platinum Standardized Plan

Does Value Benchmark Platinum Standardized Plan cover levothyroxine?

Value Benchmark Platinum Standardized Plan
68781-68781UT0200038-0 · ACA · ACA Marketplace
levothyroxine
levothyroxineunder Value Benchmark Platinum Standardized Plan
Covered — some forms require step therapy
12 of 70 covered forms have a condition attached. You may need to try a cheaper medication first — your doctor’s office handles it.
What you'd pay
$10per 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.

Tier
Preferred brand
Approval first
Not needed
Try another first
Required
Amount limit
None
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 (70)

  • levothyroxine sodium 0.013 MG Oral CapsuleTry another first
  • levothyroxine sodium 0.025 MG Oral CapsuleTry another first
  • levothyroxine sodium 0.025 MG Oral Tablet
  • levothyroxine sodium 0.025 MG Oral Tablet [Euthyrox]
  • levothyroxine sodium 0.025 MG Oral Tablet [Levo-T]
  • levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl]
  • levothyroxine sodium 0.025 MG Oral Tablet [Unithroid]
  • levothyroxine sodium 0.05 MG Oral CapsuleTry another 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]
  • levothyroxine sodium 0.05 MG Oral Tablet [Levoxyl]
  • levothyroxine sodium 0.05 MG Oral Tablet [Unithroid]
  • levothyroxine sodium 0.075 MG Oral CapsuleTry another 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]
  • levothyroxine sodium 0.075 MG Oral Tablet [Levoxyl]
  • levothyroxine sodium 0.075 MG Oral Tablet [Unithroid]
  • levothyroxine sodium 0.088 MG Oral CapsuleTry 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]
  • levothyroxine sodium 0.088 MG Oral Tablet [Levoxyl]
  • levothyroxine sodium 0.088 MG Oral Tablet [Unithroid]
  • levothyroxine sodium 0.1 MG Oral CapsuleTry 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]
  • levothyroxine sodium 0.1 MG Oral Tablet [Levoxyl]
  • levothyroxine sodium 0.1 MG Oral Tablet [Unithroid]
  • levothyroxine sodium 0.112 MG Oral CapsuleTry another first
  • levothyroxine sodium 0.112 MG Oral Tablet
  • levothyroxine sodium 0.112 MG Oral Tablet [Euthyrox]
  • levothyroxine sodium 0.112 MG Oral Tablet [Levo-T]
  • levothyroxine sodium 0.112 MG Oral Tablet [Levoxyl]
  • levothyroxine sodium 0.112 MG Oral Tablet [Unithroid]
  • levothyroxine sodium 0.125 MG Oral CapsuleTry another first
  • levothyroxine sodium 0.125 MG Oral Tablet
  • levothyroxine sodium 0.125 MG Oral Tablet [Euthyrox]

← All coverage for levothyroxine