Benefily
Varies by plan

Does Capital Advantage Insurance Company require prior authorization for Trulicity?

Prior authorization for Trulicity differs across Capital Advantage Insurance Company'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]155130023 / 2323023Prior authorization required
0.5 ML dulaglutide 3 MG/ML Auto-Injector [Trulicity]155130623 / 2323023Prior authorization required
0.5 ML dulaglutide 6 MG/ML Auto-Injector [Trulicity]239577923 / 2323023Prior authorization required
0.5 ML dulaglutide 9 MG/ML Auto-Injector [Trulicity]23957850 / 23000Not 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
Capital Blue Cross Basic (PPO)H3923-0483YesNoYes
Capital Blue Cross Basic (PPO)H3923-0483YesNoYes
Capital Blue Cross Basic (PPO)H3923-0483YesNoYes
Capital Blue Cross Classic (PPO)H3923-0133YesNoYes
Capital Blue Cross Complete (PPO)H3923-0473YesNoYes
Capital Blue Cross Complete (PPO)H3923-0473YesNoYes
Capital Blue Cross Complete (PPO)H3923-0473YesNoYes
Capital Blue Cross Complete (PPO)H3923-0473YesNoYes
Capital Blue Cross Complete (PPO)H3923-0473YesNoYes
Capital Blue Cross Enhanced (PPO)H3923-0463YesNoYes
Capital Blue Cross Enhanced (PPO)H3923-0463YesNoYes
Capital Blue Cross Enhanced (PPO)H3923-0463YesNoYes
Capital Blue Cross Enhanced (PPO)H3923-0463YesNoYes
Capital Blue Cross Prime (PPO)H3923-0173YesNoYes
Capital Blue Cross Select (PPO)H3923-0443YesNoYes
Capital Blue Cross Select (PPO)H3923-0443YesNoYes
Capital Blue Cross Select (PPO)H3923-0443YesNoYes
Capital Blue Cross Select (PPO)H3923-0443YesNoYes
Capital Blue Cross Value (PPO)H3923-0453YesNoYes
Capital Blue Cross Value (PPO)H3923-0453YesNoYes
Capital Blue Cross Value (PPO)H3923-0453YesNoYes
Capital Blue Cross Value (PPO)H3923-0453YesNoYes
Capital Blue Cross Value (PPO)H3923-0453YesNoYes
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.