Benefily
Varies by plan

Does Alignment Healthcare require prior authorization for Trulicity?

Prior authorization for Trulicity differs across Alignment Healthcare's Medicare Part D plans and product strengths — 3 of 4 Trulicity products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.

Some plans require authorization and others do not. The member's specific plan decides.

  • This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
0.5 ML dulaglutide 1.5 MG/ML Auto-Injector [Trulicity]155130067 / 6767067Prior authorization required
0.5 ML dulaglutide 3 MG/ML Auto-Injector [Trulicity]155130667 / 6767067Prior authorization required
0.5 ML dulaglutide 6 MG/ML Auto-Injector [Trulicity]239577967 / 6767067Prior authorization required
0.5 ML dulaglutide 9 MG/ML Auto-Injector [Trulicity]23957850 / 67000Not on formulary

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — 0.5 ML dulaglutide 1.5 MG/ML Auto-Injector [Trulicity]

Trulicity has 4 products in the corpus; this table is for 0.5 ML dulaglutide 1.5 MG/ML Auto-Injector [Trulicity], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Alignment Health + Intermountain Health (HMO)H9686-0093YesNoYes
Alignment Health Advantage PPO (PPO)H8832-0013YesNoYes
Alignment Health Advantage PPO (PPO)H8832-0023YesNoYes
Alignment Health AllCare Preferred (HMO)H3815-0113YesNoYes
Alignment Health AVA (PPO)H7074-0013YesNoYes
Alignment Health Balance (HMO C-SNP)H3815-0333YesNoYes
Alignment Health Balance (PPO)H4961-0063YesNoYes
Alignment Health BreathEasy (HMO C-SNP)H3815-0413YesNoYes
Alignment Health Clarity (HMO C-SNP)H3815-0423YesNoYes
Alignment Health CommUnity (HMO)H3815-0463YesNoYes
Alignment Health Dual Select+ (HMO-POS D-SNP)H5472-0073YesNoYes
Alignment Health Freedom (PPO)H8832-0033YesNoYes
Alignment Health Harmony (HMO)H3815-0313YesNoYes
Alignment Health Heart & Diabetes (HMO C-SNP)H3443-0033YesNoYes
Alignment Health Heart & Diabetes (HMO C-SNP)H3815-0103YesNoYes
Alignment Health Heart & Diabetes (HMO C-SNP)H9686-0043YesNoYes
Alignment Health Heart & Diabetes (HMO-POS C-SNP)H5472-0023YesNoYes
Alignment Health Heart & Diabetes Access (HMO C-SNP)H3815-0443YesNoYes
Alignment Health Heart & Diabetes AZPlus (HMO C-SNP)H3443-0073YesNoYes
Alignment Health Heart & Diabetes CalPlus (HMO C-SNP)H3815-0393YesNoYes
Alignment Health Heart & Diabetes Care (HMO C-SNP)H3815-0483YesNoYes
Alignment Health Heart & Diabetes Care (HMO C-SNP)H3815-0543YesNoYes
Alignment Health Heart & Diabetes Care (HMO C-SNP)H5296-0113YesNoYes
Alignment Health Heart & Diabetes Choice (HMO C-SNP)H3815-0513YesNoYes
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)H5296-0093YesNoYes
Alignment Health Heart & Diabetes NVPlus (HMO C-SNP)H9686-0063YesNoYes
Alignment Health Heart & Diabetes Plus (HMO C-SNP)H3443-0063YesNoYes
Alignment Health Heart & Diabetes Plus (HMO-POS C-SNP)H5472-0043YesNoYes
Alignment Health Honor+ Plan (HMO)H3815-0523YesNoYes
Alignment Health L.A. Premium Giveback (HMO)H3815-0553YesNoYes
Alignment Health My Choice (HMO)H3815-0013YesNoYes
Alignment Health My Choice (HMO)H3815-0283YesNoYes
Alignment Health My Choice (PPO)H4961-0013YesNoYes
Alignment Health My Choice (PPO)H4961-0033YesNoYes
Alignment Health My Choice CalCare (HMO)H3815-0503YesNoYes
Alignment Health My Choice Select (HMO)H3815-0493YesNoYes
Alignment Health NC Duals (HMO-POS D-SNP)H5296-0043YesNoYes
Alignment Health Platinum (HMO)H5296-0033YesNoYes
Alignment Health Platinum + Instacart (HMO-POS)H3815-0163YesNoYes
Alignment Health Platinum + Instacart (HMO)H3815-0083YesNoYes
Alignment Health Platinum + Instacart (HMO)H5296-0073YesNoYes
Alignment Health Platinum + Instacart (HMO)H9686-0073YesNoYes
Alignment Health Platinum Select (HMO)H5296-0103YesNoYes
Alignment Health S.D. Premium Giveback (HMO)H3815-0563YesNoYes
Alignment Health Silicon (HMO C-SNP)H3815-0453YesNoYes
Alignment Health smartHMO (HMO-POS)H5472-0033YesNoYes
Alignment Health smartHMO (HMO)H3443-0053YesNoYes
Alignment Health smartHMO (HMO)H3815-0133YesNoYes
Alignment Health smartHMO (HMO)H3815-0383YesNoYes
Alignment Health smartHMO (HMO)H3815-0403YesNoYes
Alignment Health smartHMO (HMO)H5296-0063YesNoYes
Alignment Health smartHMO (HMO)H5296-0083YesNoYes
Alignment Health smartHMO (HMO)H9686-0083YesNoYes
Alignment Health smartSavings (HMO-POS)H5472-0103YesNoYes
Alignment Health smartSavings (HMO)H3815-0473YesNoYes
Alignment Health Sutter Advantage +More (HMO)H3815-0193YesNoYes
Alignment Health Sutter Advantage +More (HMO)H3815-0203YesNoYes
Alignment Health Sutter Advantage +More (HMO)H3815-0213YesNoYes
Alignment Health Sutter Advantage +More (HMO)H3815-0233YesNoYes
Alignment Health the ONE (HMO D-SNP)H9686-0053YesNoYes
Alignment Health the ONE (HMO)H3815-0343YesNoYes
Alignment Health the ONE + Walgreens (HMO-POS)H5472-0013YesNoYes
Alignment Health the ONE + Walgreens (HMO)H3443-0013YesNoYes
Alignment Health the ONE + Walgreens (HMO)H3443-0023YesNoYes
Alignment Health the ONE + Walgreens (HMO)H3815-0353YesNoYes
Alignment Health Total Dual+ (HMO-POS D-SNP)H5472-0093YesNoYes
Alignment Health ValorCare (HMO)H3815-0533YesNoYes
Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Trulicity at other payers

Or see Trulicity across every payer at once.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.