Jardiance cost with Medicare

In this article:

• How Medicare covers prescription drugs
• Does Medicare cover Jardiance?
• What is the cost of Jardiance on Medicare?
• How the prescription drug law affects Jardiance
• Jardiance coupons for Medicare
• Other ways to save on Jardiance

In this article

• How Medicare covers prescription drugs
• Does Medicare cover Jardiance?
• What is the cost of Jardiance on Medicare?
• How the prescription drug law affects Jardiance
• Jardiance coupons for Medicare
• Other ways to save on Jardiance

Jardiance is a brand-name drug that was initially approved by the Food and Drug Administration (FDA) to control blood sugar in adults with Type 2 diabetes. It has since achieved additional approvals, including the treatment of children 10 years and older with Type 2 diabetes when combined with diet and exercise. Additional approvals include:

• Reducing the risk of cardiovascular death and hospitalization in adults with heart failure as well as in adults with established Type 2 diabetes and cardiovascular disease
• Reducing the risk of cardiovascular death, hospitalization, and worsening kidney damage in adults with chronic kidney disease (CKD)

“It is part of a class of drugs called sodium-glucose cotransporter 2 (SGLT2) inhibitors. This type of medication is a glucose absorption inhibitor,” explained dietitian and certified diabetes educator Angela Ginn-Meadow. 

People who take Jardiance are often on it for life. Their prescriptions need to be refilled on time to keep their blood sugar levels in the safe zone. Fortunately, most Medicare and commercial insurance plans cover Jardiance. With Medicare coverage, the average patient can expect to pay up to $20 monthly for Jardiance. 

How Medicare covers prescription drugs

If you are eligible for Medicare, you may know that different parts cover different types of healthcare. 

• Original Medicare Parts A and B provide health insurance for inpatient and outpatient health services respectively, among other services.
• Medicare Part D is a type of insurance plan that covers many some prescription drugs and is offered as an optional add-on to original Medicare.
• Medicare Part C (Medicare Advantage) is a way of receiving your Medicare benefits through an approved private insurance company instead of through Original Medicare. Most Medicare Advantage Plans include prescription drug coverage (Parts A, B, and D). 

Different Medicare drug plans have different drug formularies—lists of medications the plan covers. All Medicare drug plans, regardless of whether part of a Medicare Advantage plan or a stand-alone Part D plan, must cover at least two drugs in most prescription drug categories. That means each Medicare drug plan covers multiple anti-diabetic drugs.

Does Medicare cover Jardiance?

Medicare Part D plans may cover a variety of anti-diabetic drugs, according to the Centers for Medicare and Medicaid Services. This usually includes Jardiance, but when it does, it may require prior authorization, according to Blair Gingerich, Pharm.D., an ambulatory care pharmacist in northern Indiana.

Here’s why: Medicare covers SGLT2 inhibitors, but Jardiance is only one of several SGLT2 inhibitors. Remember, Medicare Part D plans are only required to cover two medications in each drug class, and these vary from plan to plan. Dr. Gingerich also says that not all Medicare Part D plans cover a drug’s total cost. 

RELATED: Does Medicaid cover Jardiance?

What is the cost of Jardiance on Medicare?

More than 1 million Medicare Part D beneficiaries filled prescriptions for Jardiance in 2022, according to an official Jardiance fact sheet from the Department of Health and Human Services. Most paid about $490 for Jardiance in 2022, which is about $41 per month. Part D beneficiaries who were eligible for the low-income subsidy, also called the Medicare Extra Help program, paid less—$20 annually, or an average of $1.67 monthly. 

* As of December 2022

Ultimately, the cost of Jardiance on Medicare depends on the specifics of your Medicare Part D plan. Factors that may influence your cost of Jardiance include whether you qualify for the Extra Help program and the coverage phase you’re in. Copays will also vary by plan formulary, choice of pharmacy, and other factors.

How the prescription drug law affects Jardiance

In January 2023, a new prescription drug law went into effect as part of the Inflation Reduction Act. The law will allow Medicare to negotiate directly with pharmaceutical companies to improve access to affordable prescription drug costs. Ten drugs were selected for the first round of negotiations, and Jardiance was one of them. That means a new, negotiated price for Jardiance will be effective in 2026.

This is the first time the Medicare program has been able to negotiate with drug companies for lower prices of brand-name prescription drugs. Exactly how low the negotiation process drives costs remains to be seen, but it is being considered a significant step. And according to Medicare, negotiated prices will benefit Medicare enrollees in several ways:

• More vaccines covered – People with Medicare can now receive several vaccines—shingles, whooping cough, and more—at zero cost.
• Lower costs for insulin – Under the new law, people with Medicare drug plans cannot be charged more than $35 for a one-month supply of insulin.
• Lower out-of-pocket drug costs – The law helps lower drug costs in several ways, including an Extra Help expansion, a Part D out-of-pocket cost cap of $2,000 starting in 2025, and lower Part B drug costs in certain situations.

Jardiance coupons for Medicare

If you’re wondering whether you can save on Jardiance with coupons, the good news is that you can—even those with drug coverage through Medicare Part D. However, you might not be able to double dip by using both. It’s a good idea to ask a pharmacist to compare what Jardiance would cost with a coupon versus with Medicare to ensure you save as much as possible.

With a SingleCare prescription discount card, you can access Jardiance coupons to use at your preferred pharmacy. At the time this article was written, Jardiance was available for $526.69 for 30, 25 mg tablets. That’s about $300 less than the average retail cost.

Other ways to save on Jardiance

Jardiance is a high-cost drug. But it’s also necessary for many patients with Type 2 diabetes. Fortunately, there are ways to save.

Medicare Extra Help program

As mentioned previously, the Medicare Extra Help program is a federal subsidy that helps Medicare Part D beneficiaries afford their medications. There are eligibility criteria, however. To be considered, a person must live in the United States and be enrolled in or willing to enroll in Medicare Part D. Then, the applicant must meet specific resource and income limits, which are detailed on the website.

Patient assistance programs for Jardiance

Boehringer Ingelheim, the company that makes Jardiance, has a patient assistance program called BI Cares. The program provides Boehringer Ingelheim drugs at no cost to patients in the United States or one of its territories who meet its eligibility requirements. Medicare beneficiaries may be eligible if their Part D plan doesn’t provide enough coverage to make Jardiance affordable.

Jardiance alternatives

Currently, per Ginn-Meadow and Dr. Gingerich, there is no generic version of Jardiance. However, there are other SGLT2 inhibitors—other drugs that have similar chemical structures and ways of acting in the body.

Other SGLT2s include:

• Farxiga
• Invokana
• Steglatro

RELATED: Jardiance alternatives: What can I take instead of Jardiance?

“There is a possibility that one SGLT2 may be preferred over the other on an individual’s insurance plan,” Dr. Gingerich said. “However, there is research that states that some SGLT2 inhibitors are better than others at preventing heart disease or reducing kidney disease.” In other words, not all SGLT2s are appropriate for someone prescribed Jardiance for cardiovascular disease or chronic kidney disease.

If Jardiance is prescribed for blood sugar control, Ginn-Meadow points out that there is also a “combination pill” that includes empagliflozin, the active ingredient in Jardiance, and metformin. This medication, called Synjardy, may be an alternative to Jardiance for some patients. Some patients may be given two separate prescriptions, one for Jardiance and a separate one for metformin.

RELATED: Jardiance vs. Metformin

Ultimately, only a healthcare provider who understands a patient’s medical history and condition can choose which prescription drug is best for that patient.