Does Humana Cover Trulicity?
The verdict
Conditional on most plans
Humana covers Trulicity for type 2 diabetes with prior authorization on Medicare Part D and Medicaid — it is not covered for weight loss. Trulicity has no weight-loss FDA indication, so requests coded with obesity diagnoses (E66.x) are denied. The 2026 Medicare GLP-1 Bridge does not include Trulicity; the Bridge covers only specified weight-loss GLP-1s (Wegovy, Foundayo, Zepbound KwikPen). Verify your specific Humana plan's formulary.
Coverage is set by your specific plan and formulary. This is a research summary — always confirm with Humana using your member ID.
Key facts
Trulicity is FDA-approved for type 2 diabetes and cardiovascular risk reduction — not for weight loss. Medicare and most plans cover it for diabetes with prior authorization.
FDA Drug Labeling, dulaglutide (Trulicity)
The 2026 Part D out-of-pocket cap is $2,100. Most continuous Trulicity users reach the cap within 2–3 months and pay $0 for the rest of the year.
CMS Medicare Part D 2026 parameters
The Lilly Trulicity Savings Card reduces cost to as little as $25 per 1–3 month fill for commercially insured patients — it explicitly excludes Medicare, Medicaid, and TRICARE.
Lilly Trulicity Savings Card terms
Medicare vs. commercial coverage
Whether Humana covers Trulicity depends heavily on which kind of plan you hold. They follow completely different rules — here's each one, side by side.
Medicare
Part D & Advantage plans
Humana Medicare Part D covers Trulicity for type 2 diabetes (ICD-10 E11.x) with prior authorization. Trulicity is typically placed on a specialty or brand tier with 25% coinsurance after the deductible; continuous users can expect to hit the 2026 $2,100 out-of-pocket cap within 2–3 months, after which cost is $0 for the rest of the year. Trulicity is NOT in the 2026 Medicare GLP-1 Bridge (July 1, 2026 – Dec 31, 2027, $50/month copay) — that demonstration covers only weight-loss GLP-1s. Coverage is for diabetes only; weight-loss-coded requests are denied. Verify on Humana's Medicare Plan Finder drug search.
Commercial / Employer
Group & marketplace plans
Humana has a limited commercial/employer footprint; most Humana Trulicity readers are Part D members. On Humana commercial plans (where present), Trulicity is covered for type 2 diabetes with prior authorization. The Lilly Trulicity Savings Card ($25 per 1–3 month fill) is usable only for commercially insured members — it explicitly excludes Medicare and Medicaid, so Humana's dominant Medicare reader cannot use it. ACA/individual plans are n/a for Humana. On Humana Medicaid, Trulicity is covered for diabetes with prior authorization where Humana administers Medicaid; state-specific rules apply.
The 4 boxes you must tick to get approved
Commercial plans that will consider Trulicity require prior authorization. Check off what applies to you to see how close you are — this is a guide, not a guarantee of approval.
Meet all 4 and you have a documented case for approval. Missing any one is the most common reason requests are denied.
Your cost, three ways
What Trulicity actually costs you swings enormously depending on how it's covered. Here's the realistic range.
Paying cash
Trulicity list price approximately $987/month; retail ~$1,390/month (Drugs.com reference). Verify current pricing at your pharmacy.
List price with no coverage — before any manufacturer savings card.
With coverage
For Humana Medicare Part D members: 25% coinsurance on specialty tier after deductible, up to the 2026 $2,100 annual out-of-pocket cap. After cap is reached, $0 for the rest of the year. For commercial members: Lilly Trulicity Savings Card may reduce cost to as little as $25 per 1–3 month fill (commercial only).
Typical monthly copay once prior authorization is approved.
Bridge program
The 2026 Medicare GLP-1 Bridge ($50/month fixed copay) does NOT cover Trulicity. For low-income or uninsured patients, Lilly Cares patient assistance may apply. MFN deal set a Trulicity reference price of $389/month (implementation timeline varies).
Reduced copay through the assistance program, where eligible.
All figures are estimates; actual cost varies by plan tier, pharmacy, and deductible status. Confirm with your Humana plan's drug pricing tool.
Check YOUR exact coverage in 3 steps
General answers only get you so far. Here's how to confirm your own plan's decision in a few minutes.
- 1
Search Humana's Medicare Plan Finder formulary
Go to Humana.com or Medicare.gov Plan Finder and use the drug search tool with your specific plan ID. Look up 'dulaglutide' or 'Trulicity' to see your plan's tier, prior auth requirements, and estimated copay.
- 2
Call Humana Member Services and request prior auth
Call the number on your Humana ID card. Confirm T2D diagnosis documentation (A1c, metformin trial) is in hand before calling. Ask whether your specific plan requires a PA form or if your prescriber must submit it electronically.
- 3
Ask your prescriber to submit the prior authorization
Your doctor submits the PA with your diabetes diagnosis (ICD-10 E11.x) and supporting labs. Do not code the request as weight loss; weight-loss requests are denied. If denied, ask about the appeals process or discuss the Lilly Trulicity Savings Card for commercial coverage.
Options if Humana won't cover Trulicity
A denial isn't the end of the road. These are the paths people commonly explore next — discuss any of them with your prescriber.
Ozempic (semaglutide)
Another GLP-1 FDA-approved for type 2 diabetes; similar PA requirements. Compare tiers on your specific Humana plan — one may be preferred over the other.
Mounjaro (tirzepatide)
GIP/GLP-1 agonist FDA-approved for T2D. Not covered for weight loss on standard Humana plans. Check your Humana formulary for tier placement vs. Trulicity.
Generic metformin
First-line oral diabetes therapy; very low cost and broadly covered on all Humana lines. Often the required step before a GLP-1 is approved.
Compounded semaglutide or tirzepatide (via Curex)
A weight-management option that does not require insurance or prior authorization. Not the same medication as Trulicity; see the Curex section below.
These options are listed for information only — your own clinician decides what is appropriate for you.
❓Frequently Asked Questions
No. The 2026 Medicare GLP-1 Bridge (July 1, 2026 – December 31, 2027, $50/month) covers only specified weight-loss GLP-1s: all Wegovy formulations, Foundayo, and the Zepbound KwikPen. Trulicity is a type 2 diabetes drug with no weight-loss indication and is explicitly not in the Bridge. Humana serves as the Bridge's central processor, but that does not change which drugs the Bridge covers.
No. Trulicity (dulaglutide) is FDA-approved only for type 2 diabetes and cardiovascular risk reduction — it has no FDA weight-loss indication. Humana, like all major insurers, will not cover Trulicity for weight-loss purposes. Requests coded with obesity diagnoses (ICD-10 E66.x) are denied. If weight management is the goal, discuss with your provider whether a weight-loss-approved medication is appropriate.
Only for Humana commercial members. The Lilly Trulicity Savings Card ($25 per 1–3 month fill; 92% of commercially insured pay $30 or less) explicitly excludes Medicare, Medicaid, TRICARE, and VA. Most Humana Trulicity readers are Medicare Part D members and cannot use this card. Lilly Cares patient assistance may be available for low-income or uninsured individuals — call 1-800-545-5979.
Trulicity is typically placed on a specialty or brand tier with 25% coinsurance after the deductible. Under the 2026 $2,100 annual Part D out-of-pocket cap, most continuous Trulicity users reach the cap within 2–3 months, after which cost is $0 for the remainder of the year. Exact amounts depend on your specific Humana plan — verify on Humana's drug pricing tool.
Typically: confirmed type 2 diabetes diagnosis (ICD-10 E11.x), recent A1c documentation, and evidence of a metformin trial or contraindication. Some plans also require a step with one additional agent. Your prescriber submits the PA. Using an obesity diagnosis code will result in denial — the T2D diagnosis is what drives coverage. Verify specific requirements on your Humana plan's formulary page.
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Read moreA weight-management path that skips insurance and prior auth
Curex offers compounded semaglutide from $49/month and compounded tirzepatide from $149/month at getcurex.com/cl/glp — no insurance and no prior authorization required. This is compounded semaglutide/tirzepatide and is not the same medication as Trulicity. Compounded medications have not been approved by the FDA and the FDA has not evaluated their safety or efficacy. Prescription required, subject to provider review.
- Medication + free shipping
- 24/7 provider access
- Medical intake & prescription review
Compounded semaglutide and tirzepatide are not the same medications as Trulicity and are not branded or FDA-approved products. Compounded medications have not been approved by the FDA and the FDA has not evaluated their safety or efficacy.
This content is for informational purposes only and does not constitute medical, financial, or insurance advice. Coverage rules, prior-authorization criteria, and copay amounts change frequently and vary by plan, formulary tier, and effective date — always verify current benefits directly with Humana before making any decision. Consult a licensed healthcare provider and your plan administrator for guidance specific to your situation. Curex offers compounded semaglutide and tirzepatide, which are not the same medications as Trulicity and are not branded or FDA-approved products; prescription required, subject to provider review. Compounded medications have not been approved by the FDA and the FDA has not evaluated their safety or efficacy.