Does Medicare Cover Trulicity?
Yes, Medicare generally covers Trulicity (dulaglutide), but only under Part D prescription drug coverage (or a Medicare Advantage plan that includes drug coverage) when it is prescribed for Type 2 diabetes. It is not covered under Original Medicare Part A or Part B because you inject it yourself at home. Coverage is not automatic, however: each plan has its own formulary (drug list), and whether Trulicity is on it, what tier it sits on, and whether rules like prior authorization apply all vary by plan. Trulicity used only for weight loss is not covered, and it is not part of the temporary Medicare GLP-1 Bridge program.
Is Trulicity covered under Part B or Part D?
Trulicity (dulaglutide) is a GLP-1 medication you inject yourself at home using a prefilled pen. Because it is a self-administered prescription drug, it falls under Medicare Part D, the part of Medicare that covers most outpatient drugs you take on your own. It is not covered under Original Medicare Part A (hospital) or Part B (medical/doctor services).
There are two ways to get Part D coverage. You can buy a stand-alone Part D drug plan to go alongside Original Medicare, or you can enroll in a Medicare Advantage plan that includes drug coverage (called an MA-PD plan). Either way, the same formulary and coverage rules described below apply within whichever plan you choose.
Covered for Type 2 diabetes — but not for weight loss alone
Trulicity's FDA-approved use is to improve blood sugar in adults with Type 2 diabetes, and to reduce the risk of certain cardiovascular events in adults with Type 2 diabetes who have heart disease or risk factors. When it is prescribed for these approved medical uses, a Part D plan can cover it.
By law, GLP-1 drugs used solely for weight loss are excluded from standard Part D coverage. Plans may cover a GLP-1 medication for an FDA-approved medical use such as Type 2 diabetes, but not for weight loss by itself. Because Trulicity's indication is diabetes (not weight management), it can be covered for diabetes care — but a plan will not cover it if it is being prescribed only to lose weight.
Why coverage depends on your plan's formulary and rules
Every Part D and Medicare Advantage drug plan publishes its own formulary, which is the list of drugs it covers. Plans decide which drugs to include and what cost tier each drug sits on, so whether Trulicity is covered — and how much you pay — varies from plan to plan. Medicare requires each formulary to include at least two drugs in most commonly prescribed categories and classes, but that does not guarantee any one specific brand like Trulicity is on the list.
Even when Trulicity is on the formulary, your plan may apply utilization-management rules before it pays:
- Prior authorization: your prescriber must show Medicare or the plan that the drug is medically necessary before it is covered.
- Step therapy: you may have to try a lower-cost alternative drug first and show it did not work well enough before the plan covers Trulicity.
- Quantity limits: the plan may limit how much it covers over a given period of time.
- Tier placement: Trulicity is often on a higher (more expensive) tier, which raises your share of the cost.
What Trulicity costs with Medicare in 2026
Your out-of-pocket cost for Trulicity depends on your specific plan's tier, deductible, and copay or coinsurance, so there is no single Medicare price. A few 2026 figures apply across Part D, however, and they protect you from runaway drug costs:
- Out-of-pocket cap: in 2026, the most you pay out of pocket for covered Part D drugs is capped at $2,100 for the year. Once you reach that cap, you pay $0 for covered Part D drugs for the rest of the year.
- Monthly premium: you pay a Part D premium in addition to drug cost-sharing, and premiums vary by plan. The 2026 national base beneficiary premium is $38.99 per month (used to calculate the late penalty).
- Higher-income surcharge (IRMAA): if your income is above certain levels, you pay an income-related adjustment on top of your Part D premium — ranging from $14.50 to $91.00 per month in 2026. It is triggered above a modified adjusted gross income of $109,000 for a single filer or $218,000 for a joint filer, based on your 2024 income.
- Late-enrollment penalty: if you go without creditable drug coverage after your Initial Enrollment Period, a permanent penalty is added to your premium — 1% of the $38.99 base premium times the number of full months you went without coverage, rounded to the nearest $0.10.
Is Trulicity in the Medicare GLP-1 Bridge program?
No. The temporary Medicare GLP-1 Bridge is a demonstration that runs from July 1, 2026 through December 31, 2027 and offers $50-per-month access to certain GLP-1 drugs used for weight reduction. The drugs available through the Bridge are all formulations of Foundayo, all formulations of Wegovy, and the KwikPen formulation of Zepbound.
Trulicity is not on that list, so you cannot get it through the Bridge program. If you take Trulicity for Type 2 diabetes, your normal Part D coverage — not the Bridge — is what applies.
What to do if your plan won't cover Trulicity
If Trulicity is not on your plan's formulary, or the plan is charging you a high tier, you and your prescriber have formal options under Medicare:
- Coverage exception: ask the plan to cover a drug that is not on its list, or to waive a rule like step therapy or a quantity limit, based on medical necessity.
- Tiering exception: ask the plan to charge you a lower cost-sharing amount than the tier Trulicity normally sits on.
- Appeal: if the plan denies your request, you have the right to appeal the decision through Medicare's multi-level appeals process.
- Ask about alternatives: if Trulicity stays uncovered, talk with your prescriber about other GLP-1 or diabetes drugs that are on your plan's formulary, which may cost you less.
Frequently asked questions
Does Medicare cover Trulicity for weight loss?
No. GLP-1 drugs used solely for weight loss are excluded from standard Part D coverage by law. Trulicity is FDA-approved for Type 2 diabetes (and cardiovascular risk reduction in adults with Type 2 diabetes), so it can be covered for those uses — but not when prescribed only to lose weight. It is also not part of the temporary GLP-1 Bridge weight-reduction program.
Why isn't my Trulicity covered when my friend's plan covers it?
Each Part D and Medicare Advantage plan chooses its own formulary, tiers, and rules. One plan may list Trulicity while another does not, or may require prior authorization or step therapy. Check your plan's drug list, and if Trulicity isn't covered you or your prescriber can request a coverage or tiering exception and, if denied, appeal.
Does Trulicity require prior authorization under Medicare?
It can. Part D plans are allowed to apply utilization-management rules to drugs like Trulicity, including prior authorization (your prescriber must show it is medically necessary), step therapy (try a lower-cost drug first), and quantity limits. Whether these apply depends on your specific plan — check the formulary.
Does Medicare Advantage cover Trulicity?
A Medicare Advantage plan that includes drug coverage (an MA-PD plan) covers Part D drugs like Trulicity through its own formulary. The same formulary placement, prior-authorization, and exception rules apply within that plan, so confirm Trulicity is covered before you enroll or fill a prescription.
What is the most I'll pay for Trulicity in 2026?
Your exact cost depends on your plan's tier and cost-sharing, but in 2026 the most you pay out of pocket for all covered Part D drugs combined is capped at $2,100 for the year. After you reach that cap, you pay $0 for covered Part D drugs for the rest of the year.
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Medicare Login Guide is an independent resource and is not affiliated with or endorsed by Medicare, the Centers for Medicare & Medicaid Services, or any government agency. This article is for general information only — confirm current figures and your specific options at medicare.gov or by calling 1-800-MEDICARE.