Trulicity® Medicare Coverage

Trulicity®
Chemical name: Dulaglutide

Typical dosage: 4 pens of 1.5mg/0.5ml

Typical type: Injection1

Trulicity® is a medication used in type 2 diabetes to improve blood sugar control. Trulicity is a once-weekly injectable medication and is only available as brand name.

Trulicity is a prescription medication that contains the active ingredient Dulaglutide. It is injected into the upper arm, abdomen, or thigh once weekly to lower blood sugar in patients with high blood sugar due to type 2 diabetes.

Trulicity promotes glucagon-like-peptide-1 (GLP-1) receptors to help your pancreas release insulin and can slow digestion in your stomach. Common side effects of Trulicity include nausea, vomiting, diarrhea, low blood sugar, stomach pain and loss of appetite.

Does Medicare cover Trulicity?

Yes! 84% of Medicare Advantage plans and Medicare Part D plans cover Trulicity.1

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.2

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Trulicity.

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Average costs for Trulicity with Medicare drug coverage1

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.
$42 – $873 $19 – $873

Additional information

Trulicity is prescribed when diet and exercise have failed to control blood sugar levels and has an added benefit of weight loss. Trulicity is provided as pre-filled syringes, and each syringe is to be used for one injection only. Ideally, Trulicity should be injected on the same day of each week, at roughly the same time of day.

Low blood sugar can happen while taking Trulicity with other diabetes medications. Signs of low blood sugar include dizziness, headache, sleepiness, weakness, hunger, shaking, confusion, and sweating. Talk to your doctor if you experience these symptoms.

Use of this medication should be closely monitored in patients with liver, kidney, stomach, or intestine abnormalities.

You should not use this medication if you have a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2) because of an increased risk for thyroid tumors.

While many patients can safely use Trulicity, it is not currently recommended for women who are pregnant due to minimal information in these individuals. It is unknown if Trulicity is present in breast milk.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 GoodRx. Trulicity. Retrieved May 2019, from www.goodrx.com/Trulicity.

2 Jacobson, Gretchen; et al. A Dozen Facts About Medicare Advantage. (Nov. 13, 2018). Kaiser Family Foundation. Retrieved from www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.