Trulicity Medicare Coverage

In this article...
  • Trulicity is a medication designed to help balance insulin levels in people with diabetes, and Medicare may help cover prescription costs. Learn more.

Diabetes is a medical condition in which an individual's blood glucose levels are higher than normal for extended periods of time. Approximately 34.2 million people in the United States have some form of diabetes, and the condition can often be treated and managed with medications such as Trulicity and lifestyle changes that include healthy diet plans and weight loss.

Does Medicare Cover Trulicity?

Approximately 84% of Medicare Advantage plans and Medicare Part D prescription plans cover Trulicity when prescribed by a medical professional. Costs and coverage can vary depending on the recipient's plan, so it's always a good idea to consult with a Medicare plan carrier to determine out-of-pocket costs and specific plan details.

Costs are also determined based on whether a recipient is in the copay or deductible stage of their specific Medicare plan. When a recipient is still in the deductible stage, they're responsible for the entire cost of their Trulicity prescription. After meeting the Medicare Part D deductible stage, recipients must usually pay a copayment or percentage portion of their covered prescriptions. As of 2022, the Medicare prescription drug plan deductible caps off at $480. 

What Are the Three Types of Diabetes?

The three types of diabetes are Type 1 diabetes, Type 2 diabetes and gestational diabetes. Type 1 diabetes often develops in childhood and is believed to be caused by an autoimmune imbalance that prevents the body from producing insulin. Type 2 diabetes develops over time and is more common in adults.

Gestational diabetes is a condition that women with no past history of diabetes develop during pregnancy. In most cases, gestational diabetes goes away following the birth of a child, but it may leave some women at higher risk for developing Type 2 diabetes later in life. Individuals with Type 1 diabetes must usually take insulin on a daily basis, and there are currently no methods known to prevent the condition from developing. Type 2 diabetes can often be prevented, delayed or managed with dietary changes and medications. 

How Does Trulicity Work?

Trulicity is an injectable glucagon-like peptide-1 antagonist or (GLP-1) dulaglutide medication that individuals with diabetes Type 1 and Type 2 use on a once-weekly basis to help manage symptoms and balance blood sugar levels. Trulicity may be beneficial to diabetics when used in conjunction with lifestyle changes, such as incorporation of a healthy diet and exercise regimen. 

Trulicity is formulated to mimic the incretin hormones in the body and help the pancreas release insulin when blood sugar levels are high. Incretin hormones have an effect on how long the body feels full after food is consumed. In people with Type 2 diabetes, the incretin hormones may not function as they should, which can lead to insulin imbalances. When injected into the bloodstream, Trulicity activates the body's GLP-1 receptors that send messages to the brain to create more insulin and slow down digestion. Trulicity may also help stop the body from releasing excess sugar into the bloodstream.

Does Trulicity Replace Insulin?

Trulicity is a non-insulin diabetes medication that does not replace insulin in diabetics, and it's most often recommended for individuals with Type 2 diabetes as a method to help control blood sugar levels. While some people with diabetes use both insulin and Trulicity to control their symptoms, the two medications are in separate classes and prescribed on a case-by-case basis.

Individuals with Type 2 diabetes produce insulin through the pancreas, but the fat, liver and muscle cells in the body do not respond correctly to the insulin once produced. Individuals with Type 1 diabetes do not produce insulin (or the body only produces low amounts) and require insulin injections. Type 2 diabetics may or may not use supplemental insulin. 

Does Trulicity Cause Any Adverse Side Effects?

Some common adverse reactions to Trulicity include decreased appetite, nausea, abdominal pain, fatigue, diarrhea and vomiting. Nausea is considered a common reaction that affects approximately 8% to 29% of users, with some users experiencing a decrease in symptoms within 2 weeks. The side effects of diarrhea and vomiting in individuals with kidney problems may lead to dehydration. 

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