Humana Trulicity drug-list check and request record

Your Humana coverage

Looking Trulicity up

• Opened the 2026 drug guide for your formulary number, not a general Humana list
• Searched the drug table and the index for Trulicity
• If listed: wrote down its tier, and whether PA or QL is shown
• If not listed: asked Customer Care for similar covered drugs and how to request a formulary exception
• Asked the pharmacy how the quantity limit is counted for your strength
• Confirmed with Customer Care that the guide is the current version

From Humana's 2026 drug guides

• Formulary 26411 (Humana Gold Plus HMO and related plans) lists the Trulicity 0.75 to 4.5 mg pens on tier 3 with PA and QL(2 per 28 days).[1]
• Trulicity does not appear in the Value Rx PDP guide (formulary 26400).[2]
• Trulicity does not appear in the Premier Rx PDP guide (formulary 26402).[3]
• You can ask Humana to waive a restriction such as prior authorization or a quantity limit, or to cover a formulary drug at a lower cost-sharing level unless it is on the specialty tier.[1]
• For an exception, Humana generally decides within 72 hours of getting the prescriber's supporting statement.[1]
• In your first 90 days as a member, Humana may cover a temporary 30-day supply of a drug that is off the formulary or restricted.[1]

Medicare rules that touch Trulicity

• People with type 2 diabetes are not eligible for the Medicare GLP-1 Bridge, even if their Part D plan does not cover a GLP-1 for diabetes.[4]
• Out-of-pocket costs for drugs a Part D plan covers are capped at $2,100 in 2026.[5]
• On January 27, 2026, CMS selected Trulicity for the third Medicare negotiation cycle; from November 2024 to October 2025 it had $4,898,378,000 in Medicare Part B and Part D spending and about 617,000 Medicare users.[6]
• CMS's deadline to publish any agreed price is November 30, 2026, and agreed prices take effect January 1, 2028.[6]

Requests and decisions

Questions for Humana Customer Care or the pharmacy

1. Which formulary number applies to my plan this year?
2. Is Trulicity on it, at what tier, and with which restrictions?
3. What does my prescriber need to send for the prior authorization?
4. If it is not covered, which similar drugs are, and how do we request an exception?
5. Am I still within my first 90 days, and can I get a transition fill?
6. What will my strength cost per fill in the deductible, initial and catastrophic phases?