Is Trulicity Covered by Insurance? Criteria, Copay, Appeal

Does insurance cover Trulicity?

Coverage for Trulicity, by plan

Plan	For type 2 diabetes	For weight loss	Prior authorization
Medicare	Covered by Part D plans	Bridge program only	Required
Medicaid	Covered	Varies by state	Required
Blue Cross Blue Shield	Covered on formulary	Plan dependent	Required
Aetna	Covered on formulary	Employer option	Required
Cigna (Evernorth / Express Scripts)	Covered on formulary	Plan dependent	Required
UnitedHealthcare (Optum Rx)	Covered on formulary	Plan dependent	Required
Kaiser Permanente	Covered on formulary	Plan dependent	Required
CVS Caremark	Covered on formulary	Plan sponsor choice	Required
Express Scripts	Covered on formulary	Plan sponsor choice	Required
Optum Rx	Covered on formulary	Plan sponsor choice	Required
Humana	Covered by Part D plans	Bridge program only	Required
TRICARE	Covered with PA	Prime and Select only	Required
VA (Veterans Health Administration)	Covered	Covered with criteria	Required
GEHA	Covered	Covered with PA	Required
Ambetter (Centene)	Covered on formulary	Excluded	Required
ACA Marketplace plans	Common	Rare	Required
Navitus	Covered on formulary	Plan sponsor choice	Not listed
Amerigroup (Elevance Medicaid)	Covered with PA	Follows state Medicaid	Required

A prior authorization checklist

• Type 2 diabetes or heart risk appears in your chart as an approved Trulicity use.
• Recent A1C results.
• Diabetes drugs you have already tried.

Sources: humana.com, medicare.gov, CMS, aetna.com.

Your appeal after a denial

1. Get the denial letter, which explains which rule was not met.
2. Your prescriber files chart notes that answer the rule with the appeal.
3. If the plan appeal does not succeed, request an external review through an independent reviewer.

What differs by state and plan

The same insurer may approve coverage for one state or employer plan but deny it for another.

• TRICARE coverage for Type 2 diabetes: Covered with PA

Each state sets Medicaid. for weight loss, GLP-1s are currently covered in 10 states: Kansas, Virginia, Missouri, Wisconsin, North Carolina, Minnesota, Delaware, Michigan, Tennessee and Mississippi. Compare all states.

Source: militaryrx.express-scripts.com.

When coverage says no, consider other routes

Prices checked November 2026. Each price sends you to the page where it comes from.

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