Does Blue Cross Blue Shield Cover Trulicity? Criteria, Copay

Blue Cross Blue Shield covers Trulicity for type 2 diabetes on its drug list, usually with prior authorization. Trulicity is approved for type 2 diabetes and heart risk, not weight loss, so the plan judges it on those uses.

For type 2 diabetes: Covered on formulary
Prior authorization: Required
For weight loss: Plan dependent

A quick look at Trulicity

How long it remains in your body

With a half-life of about 5 days, half disappears after 5 d. About 3% remains after five half-lives (25 d).

Sources: FDA label (DailyMed).

Does Blue Cross Blue Shield cover Trulicity?

Trulicity and Blue Cross Blue Shield
Medicine	Approved for	Status	Prior authorization
Trulicity	Type 2 diabetes and heart risk	Covered on formulary	Required

Sources: pricinginfo.lilly.com, trulicity.lilly.com, lillycares.com, GoodRx.

The published policy

Blue Cross Blue Shield is a federation made up of independent plans

For 2026, Blue Cross Massachusetts: dropped unless the employer holds on to it
No Appeal option is available for that exclusion:
Horizon's New Jersey rule begins January 1, 2026:
For the Federal Employee Program: policy date October 1, 2026

See the policy text at bluecrossma.org.

Sources: bluecrossma.org, horizonblue.com, info.caremark.com.

Prior authorization checklist

Diagnosis: type 2 diabetes listed in your chart, or heart risk as another approved Trulicity use.
Records: your recent A1C results and diabetes drugs that you tried earlier.
Your prescriber files the prior authorization, not you.

If denied: the appeal

Denial reasons and fixes
Denial reason	What to send or ask
Prior authorization missing	Your prescriber sends the plan's form with your type 2 diabetes diagnosis and recent A1C.
The plan wants another drug first	Ask which drugs the plan wants tried first, and send records of drugs you have tried before.
The drug is not on the plan's list	Request a formulary exception, and ask which GLP-1 the plan prefers instead.

Get the denial letter, where the exact rule that went unmet is listed.
Send chart notes that address the rule with the appeal filed by your prescriber.
If the plan's appeal fails, request an external review from an independent reviewer.

Differences by Plan and State

Trulicity coverage with other plans
Plan	For type 2 diabetes	Prior authorization
Medicare	Covered by Part D plans	Required
Medicaid	Covered	Required
Aetna	Covered on formulary	Required
Cigna (Evernorth / Express Scripts)	Covered on formulary	Required
UnitedHealthcare (Optum Rx)	Covered on formulary	Required
Kaiser Permanente	Covered on formulary	Required
CVS Caremark	Covered on formulary	Required
Express Scripts	Covered on formulary	Required
Optum Rx	Covered on formulary	Required
Humana	Covered by Part D plans	Required
TRICARE	Covered with PA	Required
VA (Veterans Health Administration)	Covered	Required
GEHA	Covered	Required
Ambetter (Centene)	Covered on formulary	Required
ACA Marketplace plans	Common	Required
Navitus	Covered on formulary	Not listed
Amerigroup (Elevance Medicaid)	Covered with PA	Required