{"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":"2025-08-05T17:24:10","modified_gmt":"2025-08-05T21:24:10","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, heart-related fatal event, and stroke in adults with Type 2 diabetes. It\u2019s available as a once-weekly injection and is usually covered by insurance.\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 don\u2019t cover any prescription medications. When Aetna does cover prescriptions, it typically 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 covers all four dosages of Trulicity as a <\/span><a href=\"https:\/\/fm.formularynavigator.com\/FBO\/41\/2025_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 plans: <\/b><span style=\"font-weight: 400;\">Aetna covers Trulicity as a <\/span><a href=\"https:\/\/www.aetna.com\/medicare\/documents\/individual\/2025\/formularies\/FORM_2025_25101B25zPPOB_EN.pdf\"><span style=\"font-weight: 400;\">Tier 3 drug<\/span><\/a><span style=\"font-weight: 400;\">.<\/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 <\/span><a href=\"https:\/\/www.aetnabetterhealth.com\/content\/dam\/aetna\/medicaid\/pdfs\/formulary-updates\/2025\/IL_H2506_25DRUG%20LST.pdf\"><span style=\"font-weight: 400;\">many cover Trulicity<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0\u00a0<\/span><\/li>\n<\/ul>\n<p><a href=\"https:\/\/engagewellnessnow.com\/contributor\/dr-pamela-tambini\/\"><span style=\"font-weight: 400;\">Pamela Tambini<\/span><\/a><span style=\"font-weight: 400;\">, 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.\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 another two years or so.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">That said, insurance companies like Aetna typically cover generic medications when available.<\/span><\/p>\n<h2 id=\"how-much-does-trulicity-cost-without-insurance\"><span style=\"font-weight: 400;\">How much does Trulicity cost without insurance?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Without insurance, Trulicity costs about $1,405 per 4, 0.5 mL of 1.5 mg\/0.5 mL autoinjector pens, amounting to a one-month supply. This is similar to the retail price of other GLP-1 receptor agonists.<\/span><\/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;\">Every Aetna plan has different copay and co-insurance rules, but you can expect to pay about $50 <\/span><a href=\"https:\/\/www.aetna.com\/content\/dam\/aetna\/pdfs\/aetnacvshealthcom\/2025-IFP-774721_58840TX0110103-01_SBC.pdf\"><span style=\"font-weight: 400;\">for a one-month supply of a preferred, non-generic drug<\/span><\/a><span style=\"font-weight: 400;\"> like Trulicity.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have prescription coverage through Medicare, your total out-of-pocket expenses for all of your 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. That\u2019s $2,000 for 2025 and $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.<\/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<h2 id=\"how-to-save-on-trulicity\"><span style=\"font-weight: 400;\">How to save on Trulicity<\/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\u2014Victoza (<\/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;\">)\u2014are available in generic versions that cost a fraction of the brand-name price. However, they may not protect the heart as well as Trulicity. 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, heart-related [&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 v27.4 (Yoast SEO v27.4) - 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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