Does Blue Cross Blue Shield cover Jardiance?

In this article:

• Does Blue Cross Blue Shield cover Jardiance?
• How much is Jardiance without insurance?
• How much does Jardiance cost with BCBS?
• How to check whether your BCBS plan covers Jardiance
• How to save on Jardiance

In this article

• Does Blue Cross Blue Shield cover Jardiance?
• How much is Jardiance without insurance?
• How much does Jardiance cost with BCBS?
• How to check whether your BCBS plan covers Jardiance
• How to save on Jardiance

Jardiance (empagliflozin) is a brand-name drug made by Boehringer Ingelheim Pharmaceuticals. It is part of a class of drugs called SGLT2 inhibitors. Jardiance has several FDA approvals. It is used to improve blood sugar levels in adults and children 10 years and older with Type 2 diabetes. In adults, Jardiance is also approved to lower the risk of cardiovascular death in people with Type 2 diabetes and heart disease, and to treat certain types of chronic kidney disease and heart failure. Jardiance can be expensive, but insurance and coupons can make it more affordable.

Does Blue Cross Blue Shield cover Jardiance?

Many Blue Cross Blue Shield (BCBS) insurance plans provide coverage for Jardiance, although out-of-pocket costs for this treatment will vary by the specific plan. According to the manufacturer of Jardiance, 93% of patients with commercial insurance, such as through an employer, pay between $0 and $50 per month for Jardiance, while 7% pay an average of $170 per month.

For people with Medicare Part D plans through Blue Cross Blue Shield, coverage also varies. 

Boehringer Ingelheim notes that about 87% of patients with Medicare Part D coverage pay $0 to $50 per month for Jardiance, while 13% pay an average of $115 per month. Your costs can also change based on which phase of your Part D benefit you are in. People who qualify for the Social Security Administration’s Extra Help program pay an average of $4.80 to $12.15 per month for Jardiance. 

If you are covered under Medicaid through Blue Cross Blue Shield, you can expect to pay $0 to $8 per month for Jardiance, according to Boehringer Ingelheim.

Some plans require prior authorization, which means that your healthcare provider will have to provide more information to your health plan on why you need a specific medicine before the insurance plan decides whether to cover it. Because coverage varies widely, the best way to find out more about your coverage and out-of-pocket costs is to check with your specific Blue Cross Blue Shield plan. Your plan representative can give you an accurate estimate of your costs.

How much is Jardiance without insurance?

Without insurance or discounts, Jardiance costs about $859 for a 30-day supply of 25 mg (the higher dose) tablets. If you use SingleCare discounts, you can pay as low as $528 per month, a savings of $331 each month, depending on your choice of pharmacy and location. You can use this free discount at over 35,000 participating pharmacies in the U.S. and Puerto Rico. 

How much does Jardiance cost with BCBS?

The cost of Jardiance with Blue Cross Blue Shield depends on your specific plan and its formulary (drug list and coverage tiers). Jardiance is often placed in Tier 2 or 3 in the list of drugs, but in some plans, it may not be preferred or may not be covered at all. Here are some sample plans with Jardiance cost information:

• Federal Employee Program (FEP) Blue Basic: $75 copay for a 30-day supply of Jardiance, or $200 for a 31- to 90-day supply (Jardiance is Tier 2 in this plan.)
• Blue Medicare Rx Enhanced: $45 or $47 for a 30-day supply of Jardiance, depending on whether the pharmacy is preferred (Jardiance is Tier 3 in this plan.)
• Anthem BCBS Nevada Medicaid: Jardiance is not covered under this plan. Generic Farxiga (dapagliflozin) is another SGLT2 inhibitor that is covered instead.

RELATED: Farxiga vs. Jardiance

Because coverage varies by plan, the best way to find out your exact cost is to check with your specific Blue Cross Blue Shield plan.

How to check whether your BCBS plan covers Jardiance 

To see whether your BCBS plan provides coverage for Jardiance, you can call the Member Service number on your member ID card. A BCBS representative can look into your prescription drug benefits and give you more information on Jardiance coverage and cost under your specific plan. 

You can also log in to your BCBS account on your plan’s website. Once logged in, you can check the formulary for Jardiance coverage information. If there is a formulary search option, you can enter the name of the drug to search for information about coverage. If the formulary opens up as a PDF document, you can press Ctrl + F and search for Jardiance in the document.

You can also ask your healthcare provider to send the prescription to your preferred pharmacy. The pharmacy staff can process the prescription and tell you right away if it is covered and how much you will have to pay. 

How to save on Jardiance

One of the most reliable ways to save on your Jardiance prescription every month is to use a SingleCare coupon. Visit the SingleCare website or use the mobile app to locate a pharmacy near you to save over $300 per month on your Jardiance prescription. You can use SingleCare on your other prescriptions as well. 

Save on diabetes treatment

There are other ways to save on Jardiance, too:

• Check the manufacturer’s website for more information on Jardiance patient assistance programs.
• If you are paying out of pocket, check with different local pharmacies for the best price. You can also ask for the price of a 30-day supply vs a 90-day supply. Some pharmacies may charge less when you purchase a larger quantity.
• Ask your healthcare provider or pharmacist about their access to local health resources, such as health departments or clinics that provide lower-cost or free services in your community. 

If your plan does not offer coverage for Jardiance, or the amount of your copay or coinsurance is not affordable, you can ask your healthcare provider about changing to a different medicine, such as a generic drug in the SGLT2 inhibitor class or in another class of prescription medications. Depending on the reason why you were prescribed Jardiance, there are various high-quality alternatives available. Your provider can help you find a more affordable Jardiance alternative that is best for your individual needs and fits into your treatment plan.