Does Medicare Cover Levothyroxine?

The thyroid gland is responsible for producing hormones that control many important body functions, including metabolism and heart rate. When the thyroid gland is underactive or not working properly, it can cause a wide range of health problems.

Your doctor might prescribe medication to restore your thyroid function. The most popular thyroid medication is levothyroxine.

When Does Medicare Pay for Levothyroxine?

Medicare Advantage (Medicare Part C) plans that includes prescription drug coverage and standalone  Medicare Part D prescription drug plans may cover levothyroxine, either in generic form or name brand versions.

Medicare Advantage and Medicare Part D plans vary in terms of their premiums, copays and coverage for specific medications. A licensed insurance agent can help you go over your options and compare costs. According to GoodRx, 100% of Medicare drugs plans in 2024 covered levothyroxine.¹

How Much Does Levothyroxine Cost?

Levothyroxine is a relatively inexpensive drug. The average monthly price for a 30-day supply is only $11.99, according to WebMD.

If you have Medicare prescription drug coverage, you may pay less than this amount for your levothyroxine. Some plans offer $0 or low copays and deductibles for the generic versions of many drugs, such as levothyroxine.

What Is Levothyroxine?

Levothyroxine treats hypothyroidism (the medical name for an underactive thyroid) by replacing the hormones your thyroid isn't producing. You generally take it once per day in the morning.

The medication should be taken on an empty stomach, preferably 30 to 60 minutes before breakfast. It can take several weeks to begin to see symptom resolution. If your body responds positively to levothyroxine, it can help improve hypothyroid symptoms, such as fatigue, weight gain, dry skin and hair and low body temperature.

How Do I Know if I Need Levothyroxine?

For many people with hyperthyroidism, the first red flag is fatigue. If you feel tired and run down all the time, even after getting enough sleep, you may have an underactive thyroid.

The thyroid gland is responsible for producing the hormones that help your body produce energy. When it isn't working properly, you may feel like you're moving through life at a snail's pace.

Other common symptoms of an underactive thyroid include weight gain, constipation and a feeling of being cold all the time. Taking your temperature in the morning can often clue you in to a sluggish thyroid. If you're regularly getting low readings, it should probably be investigated further.

If you think you may have an underactive thyroid, see your doctor for a diagnosis. Your doctor will probably start by testing your thyroid stimulating hormone (TSH). Despite its name, this is actually a pituitary hormone, rather than a thyroid hormone.

Your pituitary releases it to stimulate the thyroid to release hormones. If your thyroid is underactive, your TSH will be high, which is an indication that your pituitary is screaming at your thyroid to produce more hormones.

What Does Levothyroxine Do?

Levothyroxine is a synthetic version of the thyroid hormone T4. Your thyroid releases T4, an inactive hormone that your body then converts to its active form of T3. The synthetic version of T4 found in levothyroxine is identical to what your thyroid produces naturally.

Levothyroxine works by providing your body with pure T4, leaving it up to your body to make the conversion to T3. There are other thyroid medications that provide T3 directly or contain a combination of T4 and T3. Your doctor will determine which form of thyroid replacement is right for you.

Levothyroxine Side Effects

All thyroid medications, including levothyroxine, can cause side effects in certain patients. These side effects often occur when the dose is too high and resolve upon adjusting the dose to a more appropriate level. Some patients, however, cannot tolerate levothyroxine and must seek out alternatives.

The most common side effects of levothyroxine include:

• Headache
• Insomnia
• Diarrhea
• Changes in appetite
• Rapid heartbeat
• Increased blood pressure
• Decreased heat tolerance

What Are the Alternatives to Levothyroxine?

Levothyroxine is the most common frontline treatment for hypothyroidism. However, some people can't tolerate levothyroxine or experience negative side effects from it. Fortunately, there are several alternatives to levothyroxine that can be used to treat hypothyroidism, including the following:

• Armour Thyroid: this thyroid medication is derived from the thyroid glands of pigs, which are bioidentical to those of humans. Because it's natural, rather than synthetic, some patients prefer it to levothyroxine. However, Armour contains a combination of T4 and T3 hormones, and the ratio isn't always totally consistent from batch to batch.
  
  
• Cytomel: This is pure T3 hormone. Doctors will prescribe it if your low thyroid is the result of your body's inability to convert the T4 produced by your thyroid to T3.
  
  
• Compounded thyroid medication: This is a custom medication made by a compounding pharmacy. It usually contains a specific ratio of T4 to T3, which is determined by your doctor.