Benefily
Varies by plan

Does Bluecross Blueshield Of Tennessee, INC. require prior authorization for Trulicity?

Prior authorization for Trulicity differs across Bluecross Blueshield Of Tennessee, INC.'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]155130017 / 1717017Prior authorization required
0.5 ML dulaglutide 3 MG/ML Auto-Injector [Trulicity]155130617 / 1717017Prior authorization required
0.5 ML dulaglutide 6 MG/ML Auto-Injector [Trulicity]239577917 / 1717017Prior authorization required
0.5 ML dulaglutide 9 MG/ML Auto-Injector [Trulicity]23957850 / 17000Not 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
BlueAdvantage Diamond (PPO)H7917-0093YesNoYes
BlueAdvantage Diamond (PPO)H7917-0103YesNoYes
BlueAdvantage Diamond (PPO)H7917-0113YesNoYes
BlueAdvantage Extra (PPO)H7917-0413YesNoYes
BlueAdvantage Garnet (PPO)H7917-0323YesNoYes
BlueAdvantage Garnet (PPO)H7917-0333YesNoYes
BlueAdvantage Ruby (PPO)H7917-0123YesNoYes
BlueAdvantage Ruby (PPO)H7917-0133YesNoYes
BlueAdvantage Ruby (PPO)H7917-0143YesNoYes
BlueAdvantage Ruby (PPO)H7917-0153YesNoYes
BlueAdvantage Sapphire (PPO)H7917-0303YesNoYes
BlueAdvantage Sapphire (PPO)H7917-0313YesNoYes
BlueAdvantage Sapphire (PPO)H7917-0383YesNoYes
BlueAdvantage Sapphire (PPO)H7917-0403YesNoYes
BlueAdvantage Total Heart and Diabetes (PPO C-SNP)H7917-0443YesNoYes
BlueAdvantage Total Heart and Diabetes (PPO C-SNP)H7917-0453YesNoYes
BlueAdvantage Total Heart and Diabetes Plus (PPO C-SNP)H7917-0463YesNoYes
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.