Medicare Coverage for Jardiance: An Examination
Jumpin' Jardiance: Navigating the Medicare Maze
Jardiance is a popular med for treating type 2 diabetes and heart failure, with most Medicare Part D plans offering coverage. But, peeps, it ain't always a walk in the park figuring out what you'll shell out. Here's the lowdown!
From June 2022 to May 2023, Medicare dropped close to $7 billion on Jardiance, with an average out-of-pocket cost of $290 for enrollees in 2022. However, these costs can vary depending on your plan.
Each Medicare drug has its list, aka formulary, detailing covered meds. To get coverage for Jardiance, you gotta enroll in a prescription drug plan that includes it.
So, how much does Jardiance cost on Medicare?
Optum Perks estimates that the out-of-pocket pharmacy cost for 30 tablets of Jardiance is around $600 depending on the pharmacy. But your actual cost depends on your insurance plan and whether Jardiance is in a high or low tier (the higher the tier, the more you'll pay).
Typically, you'll also have to cough up a monthly premium for Part C and D, aside from coinsurance and copayments. About 40% of your Part B treatment cost might be your responsibility, unless you've hit your annual deductible, which can't exceed $590 in 2025.
Glossary
- Out-of-pocket cost: The money you pay for care when Medicare doesn't cover it all. This may include deductibles, coinsurance, copayments, and premiums.
- Premium: The monthly amount you pay for Medicare coverage.
- Deductible: The annual amount you must spend out of pocket before Medicare starts funding your treatments.
- Coinsurance: The percentage of treatment cost you pay yourself. For Part B, it's 20%.
- Copayment: A fixed dollar amount you pay for certain treatments, usually prescription drugs.
What tier is Jardiance with Medicare?
Each plan may assign Jardiance a different tier, and the higher the tier, the more you'll pay after coverage kicks in. In 2022, the government started negotiating new prices for Jardiance (and a few other drugs), so it might get cheaper.
Now, how can you score Jardiance for free or at a lower cost?
Some financial assistance programs like Medicaid, Extra Help, and State Pharmaceutical Assistance Programs (SPAPs) can help reduce your expenses.
Is there a cheaper alternative for Jardiance?
Since Jardiance isn't available as a generic yet, brand-name stuff tends to be more expensive.
Saving big on SGLT2 inhibitors
Jardiance belongs to the SGLT2 inhibitors—drugs that help remove excess sugar from the body by working in the kidneys. Depending on your plan, medication for diabetes, such as metformin, nateglinide, acarbose, or glyburide, might also be covered.
Apart from Jardiance,Original Medicare's Part B may cover certain diabetes drugs and IV medications not suitable for self-administration.
More resources
- Learn more: What is Medicare's drug list?
- Learn more: Jardiance (empagliflozin) and cost
- Learn more: Diabetes medications and Medicare
- Learn more: Does Medicare cover cardiovascular disease?
- With Medicare Part D plans providing coverage for Jardiance, one might assume the cost is straightforward, but it can still be complicated to determine out-of-pocket expenses.
- Out-of-pocket pharmacy costs for 30 tablets of Jardiance can range from around $600, but this amount varies based on the insurance plan and the tier categorization of Jardiance in the plan.
- Aside from Jardiance, Medicare Part B may cover certain diabetes drugs and IV medications not suitable for self-administration.
- For those with financial challenges, programs like Medicaid, Extra Help, and State Pharmaceutical Assistance Programs (SPAPs) can help reduce expenses related to Jardiance.
- Since Jardiance is not available as a generic yet, brand-name drugs tend to be more expensive than their generic counterparts, which might serve as a cheaper alternative.
- Jardiance being an SGLT2 inhibitor, diabetes medications such as metformin, nateglinide, acarbose, or glyburide may also be covered under certain Medicare plans.
- To navigate the Medicare maze effectively, understanding the glossary terms like premium, deductible, coinsurance, and copayment is crucial for managing personal-finance and health-and-wellness expenses related to therapies and treatments.
