Benefily
No prior authorization

Does Freedom Health, INC. require prior authorization for Unithroid?

Freedom Health, INC. 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]96622824 / 24000No prior authorization
levothyroxine sodium 0.088 MG Oral Tablet [Unithroid]96623224 / 24000No prior authorization
levothyroxine sodium 0.1 MG Oral Tablet [Unithroid]96623324 / 24000No prior authorization
levothyroxine sodium 0.112 MG Oral Tablet [Unithroid]96623524 / 24000No prior authorization
levothyroxine sodium 0.125 MG Oral Tablet [Unithroid]96623724 / 24000No prior authorization
levothyroxine sodium 0.15 MG Oral Tablet [Unithroid]9662380 / 24000Not on formulary
levothyroxine sodium 0.2 MG Oral Tablet [Unithroid]9662410 / 24000Not on formulary
levothyroxine sodium 0.3 MG Oral Tablet [Unithroid]9662430 / 24000Not on formulary
levothyroxine sodium 0.05 MG Oral Tablet [Unithroid]9662440 / 24000Not on formulary
levothyroxine sodium 0.175 MG Oral Tablet [Unithroid]9662460 / 24000Not on formulary
levothyroxine sodium 0.075 MG Oral Tablet [Unithroid]9662860 / 24000Not on formulary
levothyroxine sodium 0.137 MG Oral Tablet [Unithroid]9664360 / 24000Not 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
Freedom Medi-Medi Full (HMO D-SNP)H5427-0871NoNoNo
Freedom Medi-Medi Partial (HMO D-SNP)H5427-0781NoNoNo
Freedom Medicare Plan Rx (HMO)H5427-0591NoNoNo
Freedom Medicare Plan Rx (HMO)H5427-0601NoNoNo
Freedom M�ximo (HMO-POS)H5427-1121NoNoNo
Freedom M�ximo (HMO-POS)H5427-1131NoNoNo
Freedom Platinum Plan Rx (HMO)H5427-0881NoNoNo
Freedom Platinum Plan Rx (HMO)H5427-0891NoNoNo
Freedom Platinum Plan Rx (HMO)H5427-0911NoNoNo
Freedom Platinum Plan Rx (HMO)H5427-0931NoNoNo
Freedom Platinum Plan Rx (HMO)H5427-0941NoNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-0961NoNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1021NoNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1031NoNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1051NoNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1061NoNoNo
Freedom Platinum Rewards Plan Rx (HMO)H5427-1071NoNoNo
Freedom VIP Care (HMO C-SNP)H5427-0701NoNoNo
Freedom VIP Rewards (HMO C-SNP)H5427-0991NoNoNo
Freedom VIP Rewards (HMO C-SNP)H5427-1081NoNoNo
Freedom VIP Savings (HMO C-SNP)H5427-0721NoNoNo
Freedom VIP Savings (HMO C-SNP)H5427-0821NoNoNo
Freedom VIP Savings COPD (HMO C-SNP)H5427-0771NoNoNo
Freedom VIP Savings COPD (HMO C-SNP)H5427-0831NoNoNo
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.