{"id":633043,"date":"2025-08-05T17:24:10","date_gmt":"2025-08-05T21:24:10","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=633043"},"modified":"2026-06-15T11:42:39","modified_gmt":"2026-06-15T15:42:39","slug":"does-aetna-cover-trulicity","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-aetna-cover-trulicity\/","title":{"rendered":"Does Aetna cover Trulicity?"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/trulicity\"><span style=\"font-weight: 400;\">Trulicity<\/span><\/a><span style=\"font-weight: 400;\"> (dulaglutide) is a brand-name prescription medication that belongs to a class of drugs called <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/glp-1-agonists\"><span style=\"font-weight: 400;\">glucagon-like peptide-1 (GLP-1) receptor agonists<\/span><\/a><span style=\"font-weight: 400;\">. Trulicity is approved by the Food and Drug Administration to help control blood sugar levels in people 10 years and older with <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/diabetes-causes\"><span style=\"font-weight: 400;\">Type 2 diabetes mellitus<\/span><\/a><span style=\"font-weight: 400;\"> and to reduce the risk of heart attack, stroke, and heart-related death in adults with Type 2 diabetes who also have cardiovascular disease or multiple risk factors. If you have insurance through Aetna, Trulicity is often covered, but coverage varies by specific plan, and additional limitations like prior authorization may apply.\u00a0\u00a0<\/span><\/p>\n<h2 id=\"does-aetna-cover-trulicity\"><span style=\"font-weight: 400;\">Does Aetna cover Trulicity?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Drug coverage varies by plan, and some Aetna health insurance plans do not have prescription drug benefits. When Aetna does cover prescriptions, it often covers Trulicity.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Here\u2019s what you need to know:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Commercial plans: <\/b><span style=\"font-weight: 400;\">Aetna often covers all four dosages of Trulicity as a <\/span><a href=\"https:\/\/www.aetna.com\/content\/dam\/aetna\/pdfs\/aetnacom\/individuals-families-health-insurance\/document-library\/pharmacy\/2026_Drug_guide_Aetna_Standard_Plan.pdf\"><span style=\"font-weight: 400;\">preferred brand<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Medicare prescription plans: <\/b><span style=\"font-weight: 400;\">Aetna often covers Trulicity as a <\/span><a href=\"https:\/\/dgalcorn.com\/wp-content\/uploads\/2025\/10\/Aetna-2026-B2-Formulary-FORM_2026_26010B29zPPO_EN.pdf\"><span style=\"font-weight: 400;\">Tier 3 drug,<\/span><\/a><span style=\"font-weight: 400;\"> but coverage varies by plan and may include requirements such as prior authorization.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Medicaid plans:<\/b><span style=\"font-weight: 400;\"> Prescription coverage varies by state, but many cover Trulicity.\u00a0\u00a0<\/span><\/li>\n<\/ul>\n<p><a href=\"https:\/\/engagewellnessnow.com\/blog\/contributor\/dr-pamela-tambini\/\"><span style=\"font-weight: 400;\">Pamela Tambini<\/span><\/a><span style=\"font-weight: 400;\">, MD, a double board-certified physician in internal medicine and addiction medicine and Medical Director at Engage Wellness in Acton, Massachusetts, says, \u201cIn my experience, Aetna often does cover Trulicity, especially for people with Type 2 diabetes who have not had enough success with first-line treatments like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/metformin-hcl\"><span style=\"font-weight: 400;\">metformin<\/span><\/a><span style=\"font-weight: 400;\">. That said, it is usually not automatic. Most Aetna plans require <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/prior-authorization\/\"><span style=\"font-weight: 400;\">prior authorization<\/span><\/a><span style=\"font-weight: 400;\">, which means we must justify why Trulicity is medically necessary.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Under Aetna\u2019s <\/span><a href=\"https:\/\/www.aetna.com\/products\/rxnonmedicare\/data\/2024\/GLP-1_Agonist_Trulicity_PA_with_Limit_Policy_1193-C_UDR_05-2024.html\"><span style=\"font-weight: 400;\">coverage criteria<\/span><\/a><span style=\"font-weight: 400;\">, you must have a diagnosis of Type 2 diabetes and may not have received a maintenance dose of any other GLP-1 receptor agonist (such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ozempic\"><span style=\"font-weight: 400;\">Ozempic<\/span><\/a><span style=\"font-weight: 400;\"> or <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/victoza\"><span style=\"font-weight: 400;\">Victoza<\/span><\/a><span style=\"font-weight: 400;\">) for at least three months in order to be approved for a Trulicity prescription. In addition, at least one of the following statements must be true:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">You\u2019re unable to take metformin, or you\u2019ve tried metformin, and it didn\u2019t work or caused unwanted side effects.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Your blood sugar needs to be managed by more than one medication, and your <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/normal-a1c-levels\/\"><span style=\"font-weight: 400;\">A1C<\/span><\/a><span style=\"font-weight: 400;\"> is 7.5% or higher.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">You\u2019ve been diagnosed with advanced <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/chronic-kidney-disease\/\"><span style=\"font-weight: 400;\">chronic kidney disease<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">You\u2019ve been diagnosed with cardiovascular disease or have multiple risk factors for it.\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Although GLP-1 treatments have become popular for weight loss, Aetna doesn\u2019t cover Trulicity for this purpose because it is not FDA-approved for weight loss.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If your Aetna plan doesn\u2019t cover Trulicity or the company denies your prior authorization request, your healthcare provider can submit an exception request on your behalf.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cI have had patients whose Trulicity prescriptions were initially denied,\u201d Dr. Tambini says. \u201cThis usually occurs when the documentation doesn\u2019t indicate that the patient has tried other medications, such as metformin, or if the diagnosis isn\u2019t detailed enough. The good news is that if there is a strong clinical reason and we provide the proper paperwork, those denials are often reversed.\u201d<\/span><\/p>\n<h2 id=\"does-aetna-cover-generic-trulicity\"><span style=\"font-weight: 400;\">Does Aetna cover generic Trulicity?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Dulaglutide, the active ingredient in Trulicity, isn\u2019t currently available as a generic. Lilly holds exclusive manufacturer rights for Trulicity <\/span><a href=\"https:\/\/www.proclinical.com\/blogs\/2024-2\/top-10-drugs-with-patents-due-to-expire-in-the-next-5-years\"><span style=\"font-weight: 400;\">until 2027<\/span><\/a><span style=\"font-weight: 400;\">, when its U.S. patent will expire. This means generic Trulicity won\u2019t be manufactured for at least another few years.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">That said, insurance companies like Aetna typically cover generic medications when available, because they cost less and are just as safe and effective as their brand-name counterparts.<\/span><\/p>\n<h2 id=\"how-much-does-trulicity-cost\"><span style=\"font-weight: 400;\">How much does Trulicity cost?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Without insurance, Trulicity costs about $1,396 per 4, 0.5 mL of 1.5 mg\/0.5 mL injection pens, amounting to a one-month supply. This is similar to the retail price of other GLP-1 receptor agonists.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\t\t<div id=\"coupon-cta\" class=\"coupon-cta master-template\">\n\t\t\t<p id=\"headline\">Save up to 80% on Trulicity with SingleCare<\/p>\n\t\t\t<p id=\"subheadline\">Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.<\/p>\n\t\t\t<div class=\"details-wrap\">\n\t\t\t\t<div class=\"details\">\n\t\t\t\t\tTrulicity 1.5mg\/0.5mL (4 Pens)\t\t\t\t<\/div>\n\t\t\t\t<div class=\"address\">\n\t\t\t\t\t23666 - Hampton, VA\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"api-response\">\n\t\t\t\t\t\t<div class=\"coupon\">\n\t\t\t<div class=\"logo\">\n\t\t\t<img decoding=\"async\" src=\"https:\/\/images.singlecare.com\/content\/images\/pharmacy\/logo-color-walmart-nbh-market.svg\" alt=\"Walmart Neighborhood Market\" \/>\t\t\t<\/div>\n\t\t\t<div class=\"price\">\n\t\t\t\t<div class=\"price-number\">\n\t\t\t\t\t$825.15<br\/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"price-signup\">\n\t\t\t\t\t<span class=\"info-icon\">i<\/span>\n\t\t\t\t\tPrice with <a href=\"https:\/\/www.singlecare.com\/prescription\/trulicity#blog-cta\">signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"couponbtn\">\n\t\t\t\t<a target=\"_blank\" href=\"https:\/\/www.singlecare.com\/prescription\/trulicity#blog-cta\">Get free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"coupon\">\n\t\t\t<div class=\"logo\">\n\t\t\t<img decoding=\"async\" src=\"https:\/\/images.singlecare.com\/content\/images\/pharmacy\/logo-color-walmart.svg\" alt=\"Walmart Pharmacy\" \/>\t\t\t<\/div>\n\t\t\t<div class=\"price\">\n\t\t\t\t<div class=\"price-number\">\n\t\t\t\t\t$825.15<br\/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"price-signup\">\n\t\t\t\t\t<span class=\"info-icon\">i<\/span>\n\t\t\t\t\tPrice with <a href=\"https:\/\/www.singlecare.com\/prescription\/trulicity#blog-cta\">signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"couponbtn\">\n\t\t\t\t<a target=\"_blank\" href=\"https:\/\/www.singlecare.com\/prescription\/trulicity#blog-cta\">Get free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t<a target=\"_blank\" href=\"https:\/\/www.singlecare.com\/prescription\/trulicity#blog-cta\" class=\"coupon-see-all-btn\">See Trulicity prices at all pharmacies<\/a>\n\t\t<\/div>\n\n\t\t<\/span><b>\u00a0<\/b><\/p>\n<h2 id=\"how-much-does-trulicity-cost-with-aetna\"><span style=\"font-weight: 400;\">How much does Trulicity cost with Aetna?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Since there are different Aetna plans, details of specific plans may vary. What one Aetna member pays for Trulicity may not be the same amount that another pays. To find out more about Trulicity cost and coverage on your Aetna plan, you can contact your plan directly or check the most recent formulary.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have prescription coverage through an Aetna Medicare plan, your total out-of-pocket expenses for all of your covered medications will be no more than your <\/span><a href=\"https:\/\/www.cms.gov\/newsroom\/fact-sheets\/final-cy-2026-part-d-redesign-program-instructions\"><span style=\"font-weight: 400;\">out-of-pocket maximum<\/span><\/a><span style=\"font-weight: 400;\"> for the year, which is $2,100 for 2026. After you reach that amount, your prescriptions will be covered in full for the rest of the year.<\/span><\/p>\n<h2 id=\"how-to-check-whether-your-aetna-plan-covers-trulicity\"><span style=\"font-weight: 400;\">How to check whether your Aetna plan covers Trulicity\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The easiest way to check whether your Aetna plan covers Trulicity is to call the customer care number located on the back of your health insurance card. Have your member number ready so the member services representative can look up the details of your plan.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have an online Aetna account, you can log in and check your documents. The drug list, or <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-a-formulary\/\"><span style=\"font-weight: 400;\">formulary<\/span><\/a><span style=\"font-weight: 400;\">, will say whether or not Trulicity is covered. Press the CTRL and F keys simultaneously to search this long document, or look for Trulicity in the alphabetical index.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can also have your healthcare provider send a prescription to your preferred pharmacy. The pharmacy staff will process the claim, and can tell you if your prescription is covered or will need a prior authorization, and they can assist you with the next steps.<\/span><\/p>\n<h2 id=\"what-to-do-if-insurance-won-t-cover-trulicity\"><span style=\"font-weight: 400;\">What to do if insurance won\u2019t cover Trulicity<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">If your Aetna plan does not initially cover Trulicity, check with your healthcare provider and ask if they can submit a prior authorization (PA). They can submit additional documentation to your plan to explain why the medicine is necessary for you. If the PA is denied, ask if your doctor can appeal the decision.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If, despite these measures, your Trulicity prescription is still denied by your insurance plan, consult your healthcare provider. They may be able to help you with Trulicity savings or suggest a <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/trulicity-alternatives\/\"><span style=\"font-weight: 400;\">Trulicity alternative<\/span><\/a><span style=\"font-weight: 400;\"> that may be covered on your plan. There are many diabetes medications, so if Trulicity is not affordable, your healthcare provider can help you find another drug that meets your needs.<\/span><\/p>\n<p><b>Related: <\/b><a href=\"https:\/\/www.singlecare.com\/resources\/diabetes\"><b>Diabetes resources<\/b><\/a><\/p>\n<h2 id=\"how-to-get-trulicity-without-insurance\"><span style=\"font-weight: 400;\">How to get Trulicity without insurance<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There are <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/trulicity-savings\/\"><span style=\"font-weight: 400;\">ways to save money on Trulicity<\/span><\/a><span style=\"font-weight: 400;\">, whether or not Aetna covers it. For example, you can use a <\/span><a href=\"https:\/\/www.singlecare.com\/prescription-discount-card\"><span style=\"font-weight: 400;\">SingleCare prescription discount card<\/span><\/a><span style=\"font-weight: 400;\"> to save over $600 a month, depending on your choice of pharmacy and location. You can use SingleCare to compare prices at participating pharmacies. Once you find the pharmacy with the lowest coupon price, save your coupon to your free SingleCare account, print it, or send a copy to yourself via text or email. When you pick up your Trulicity prescription, show the SingleCare card to the pharmacist for your instant discount.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can also talk to your healthcare provider about more affordable alternatives. Two GLP-1 receptor agonists that are FDA approved for Type 2 diabetes, Victoza (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/liraglutide\"><span style=\"font-weight: 400;\">liraglutide<\/span><\/a><span style=\"font-weight: 400;\">) and Byetta (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/exenatide\"><span style=\"font-weight: 400;\">exenatide<\/span><\/a><span style=\"font-weight: 400;\">), are available in generic versions that cost a fraction of the brand-name price. Your healthcare provider can weigh the potential risks and benefits of different medications to find one that meets your individual needs.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Trulicity (dulaglutide) is a brand-name prescription medication that belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. Trulicity is approved by the Food and Drug Administration to help control blood sugar levels in people 10 years and older with Type 2 diabetes mellitus and to reduce the risk of heart attack, stroke, [&hellip;]<\/p>\n","protected":false},"author":149,"featured_media":633044,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[10298,608],"coauthors":[21074],"class_list":["post-633043","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-diabetes","tag-health-insurance","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.8 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Does Aetna cover Trulicity?<\/title>\n<meta name=\"description\" content=\"Aetna covers Trulicity in most of its plans, but coverage varies. 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