Benefily
No prior authorization

Does Clover Health require prior authorization for Unithroid?

Clover Health does not require prior authorization for Unithroid on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

  • This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
levothyroxine sodium 0.025 MG Oral Tablet [Unithroid]96622813 / 13000No prior authorization
levothyroxine sodium 0.088 MG Oral Tablet [Unithroid]96623213 / 13000No prior authorization
levothyroxine sodium 0.1 MG Oral Tablet [Unithroid]96623313 / 13000No prior authorization
levothyroxine sodium 0.112 MG Oral Tablet [Unithroid]96623513 / 13000No prior authorization
levothyroxine sodium 0.125 MG Oral Tablet [Unithroid]96623713 / 13000No prior authorization
levothyroxine sodium 0.15 MG Oral Tablet [Unithroid]9662380 / 13000Not on formulary
levothyroxine sodium 0.2 MG Oral Tablet [Unithroid]9662410 / 13000Not on formulary
levothyroxine sodium 0.3 MG Oral Tablet [Unithroid]9662430 / 13000Not on formulary
levothyroxine sodium 0.05 MG Oral Tablet [Unithroid]9662440 / 13000Not on formulary
levothyroxine sodium 0.175 MG Oral Tablet [Unithroid]9662460 / 13000Not on formulary
levothyroxine sodium 0.075 MG Oral Tablet [Unithroid]9662860 / 13000Not on formulary
levothyroxine sodium 0.137 MG Oral Tablet [Unithroid]9664360 / 13000Not on formulary

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — levothyroxine sodium 0.025 MG Oral Tablet [Unithroid]

Unithroid has 12 products in the corpus; this table is for levothyroxine sodium 0.025 MG Oral Tablet [Unithroid], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Clover Health Choice (PPO)H5141-0041NoNoNo
Clover Health Choice (PPO)H5141-0251NoNoNo
Clover Health Choice (PPO)H5141-0321NoNoNo
Clover Health Choice (PPO)H5141-0381NoNoNo
Clover Health Choice Giveback (PPO)H5141-0541NoNoNo
Clover Health Choice Value (PPO)H5141-0071NoNoNo
Clover Health Choice Value (PPO)H5141-0421NoNoNo
Clover Health Classic (HMO)H8010-0021NoNoNo
Clover Health LiveHealthy (PPO)H5141-0261NoNoNo
Clover Health LiveHealthy (PPO)H5141-0361NoNoNo
Clover Health LiveHealthy Giveback (PPO)H5141-0631NoNoNo
Clover Health LiveHealthy Value (PPO)H5141-0451NoNoNo
Clover Health Value (HMO)H8010-0031NoNoNo
Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Unithroid at other payers

Or see Unithroid across every payer at once.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.