Medicare Coverage for Jardiance: Explored
Rewritten Article:
Say hey to Jardiance, a medication doctors usually prescribe to tackle heart failure and type 2 diabetes. Most Medicare Part D prescription drug plans include coverage for this little helper, while Part C plans with drug coverage should too, though it depends on the particular plan.
From June 2022 to May 2023, Medicare shelled out a whopping $7 billion on Jardiance, with enrollees forking out an average of around $290 out of pocket in 2022.
Every Medicare pill has a formulary, a list of covered medications. To get covered, you gotta enroll in a prescription drug plan that lists Jardiance on its formulary.
How much does Jardiance cost on Medicare?
According to Optum Perks, the out-of-pocket pharmacy cost for 30 tablets of Jardiance is roughly $600, depending on the pharmacy you choose. The share of that cost you pay depends on your insurance plan and the tier it places Jardiance. Additionally, you gotta pay a monthly premium for parts C and D, which can vary depending on the plan.
Typically, there's also a deductible you've gotta meet before coverage kicks in. For Part D, this figure can't exceed $590 in 2025. Also, your total spending on Part D-covered drugs has an annual cap of $2,000.
Glossary of Medicare terms
- Out-of-pocket cost: This is the chunk of change you get stuck with for care when Medicare doesn't cover the whole bit or doesn't offer coverage at all. This can include deductibles, coinsurance, copayments, and premiums.
- Premium: This is the amount of money you fork over each month for Medicare coverage.
- Deductible: This is an annual amount you gotta spend out of pocket before Medicare starts chipping in for your treatments.
- Coinsurance: This is the percentage of treatment costs you gotta shell out yourself. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount you pay when receiving certain treatments under Medicare, usually for prescription drugs.
What tier is Jardiance with Medicare?
Every Medicare drug plan may place Jardiance in a different tier, and the higher the tier, the more you might end up paying after coverage comes into play.
The Inflation Reduction Act of 2022 gave the Secretary of Health and Human Services (HHS) the power to negotiate new prices for Jardiance and nine other drugs, making these drugs more wallet-friendly for enrollees.
"Learn more: What is the Medicare drug list?## How do I get Jardiance for free?
There are a few financial assistance programs available that can help you lower the expenses related to Jardiance:
- Medicaid
- Extra Help
- State Pharmaceutical Assistance Programs (SPAPs)
Is there a cheaper substitute for Jardiance?
Generic drugs are usually more wallet-friendly than brand-name drugs. However, Jardiance doesn't have a generic version available yet.
"Learn more: Jardiance (empagliflozin) and cost## What other medications for diabetes or heart disease are covered?
Jardiance falls under the category of SGLT2 inhibitors, a class of drugs that work in the kidneys to remove excess sugar from the body through urine. These drugs may have a beneficial impact on the heart and kidneys.
Whether a plan covers Jardiance or any other heart disease drug depends on the specific plan. The same goes for diabetes drugs. Here are some examples of medications for diabetes that plans might cover:
- metformin (Glumetza)
- nateglinide (Starlix)
- acarbose (Precose)
- glyburide (DiaBeta, Micronase, Glynase)
A person might want to know that Original Medicare's Part B may cover certain drugs, such as IV medications, which are typically drugs you can't administer yourself.
"Learn more: Diabetes medications and Medicare"Learn more: Does Medicare cover cardiovascular disease?
- The cost of Jardiance on Medicare is determined by its tier within a specific Medicare drug plan, and the higher the tier, the more a person may need to pay.
- The Inflation Reduction Act of 2022 has given the Secretary of Health and Human Services the power to negotiate new, more affordable prices for Jardiance and other drugs, benefiting enrollees financially.
- To lower the expenses related to Jardiance, a person can explore financial assistance programs such as Medicaid, Extra Help, or State Pharmaceutical Assistance Programs (SPAPs).
