Does Blue Cross Blue Shield cover Jardiance?

In this article:

• Does BCBS cover Jardiance?
• Jardiance without insurance
• Cost with BCBS
• How to check your coverage
• How to save

In this article

• Does BCBS cover Jardiance?
• Jardiance without insurance
• Cost with BCBS
• How to check your coverage
• How to save

Many Blue Cross Blue Shield plans cover Jardiance, a brand-name SGLT2 inhibitor used to manage Type 2 diabetes and certain heart and kidney conditions. Insurance coverage and out-of-pocket costs depend on your BCBS plan, the plan’s formulary, and whether additional medical documentation is needed. Because BCBS is a federation of independent plans, benefits often vary from state to state and between commercial, Medicare, and Medicaid plans.

Does Blue Cross Blue Shield cover Jardiance?

Many Blue Cross Blue Shield (BCBS) plans cover Jardiance, though out-of-pocket costs will vary by plan. According to the manufacturer of Jardiance, 94% of patients with employer-sponsored commercial insurance pay between $0 and $50 per month, while 6% pay an average of $230 per month.

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

Boehringer Ingelheim notes that about 84% of patients with Medicare Part D coverage pay $0 to $50 per month for Jardiance, while 16% pay an average of $166 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 no more than $12.65 per month for Jardiance in 2026 (the federal cap on brand-name copays for full Extra Help).

If you are covered under Medicaid through Blue Cross Blue Shield, you can expect to pay $0 to $10 per month for Jardiance, according to Boehringer Ingelheim. Since Medicaid is administered at the state level, coverage and copay amounts can vary by state.

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 $819 for a 30-day supply of 25 mg tablets (the higher dose). If you use SingleCare discounts, you can pay as low as $255 per month, potentially saving over $500 each month, depending on the 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: Jardiance is a Tier 2 preferred brand drug. Your share is 35% of the plan allowance, up to $150 for a 30-day supply or $400 for a 31- to 90-day supply.
• 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 covers Jardiance, call the Member Service number on your member ID card. A BCBS representative can look into your prescription drug benefits and provide more information on Jardiance coverage and costs 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.

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 potentially 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 cover Jardiance, or the amount of your copay or coinsurance is not affordable, you can ask your healthcare provider about switching to a different medicine, such as a generic SGLT2 inhibitor or 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.