{"id":628485,"date":"2024-06-06T15:46:11","date_gmt":"2024-06-06T19:46:11","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=628485"},"modified":"2026-07-14T15:29:23","modified_gmt":"2026-07-14T19:29:23","slug":"jardiance-cost-with-medicare","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/jardiance-cost-with-medicare\/","title":{"rendered":"Jardiance cost with Medicare: What to expect"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/jardiance\/what-is\">Jardiance<\/a> (empagliflozin) is a sodium-glucose co-transporter 2 (SGLT2) inhibitor that\u2019s been approved by the Food and Drug Administration (FDA) to treat Type 2 diabetes in people 10 years and older and to reduce the risk of complications in adults with heart disease or chronic kidney disease. It can be expensive with or <a href=\"https:\/\/www.singlecare.com\/blog\/jardiance-without-insurance\/\">without insurance<\/a> coverage, but <a href=\"https:\/\/www.cms.gov\/files\/document\/fact-sheet-negotiated-prices-initial-price-applicability-year-2026.pdf\">price negotiations<\/a> related to the Inflation Reduction Act cap the cost of Jardiance with Medicare at $197 per 30 tablets for 2026.<\/p>\n<h2 id=\"does-medicare-cover-jardiance\">Does Medicare cover Jardiance?<\/h2>\n<p>Yes, many Medicare prescription drug plans cover Jardiance for <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=faf3dd6a-9cd0-39c2-0d2e-232cb3f67565\">FDA-approved indications<\/a>, which include:<\/p>\n<ul>\n<li>Controlling blood sugar in people 10 years and older with Type 2 diabetes<\/li>\n<li>Reducing the risk of cardiovascular-related death in adults with Type 2 diabetes and heart disease<\/li>\n<li>Reducing the risk of cardiovascular-related hospitalization and death in adults with heart failure<\/li>\n<li>Reducing the risk of worsening kidney filtration, end-stage kidney disease, and cardiovascular-related hospitalization and death in adults with chronic kidney disease<\/li>\n<\/ul>\n<p>\u201cIn my experience, most Medicare Part D plans cover Jardiance. But coverage doesn\u2019t mean access will always be easy,\u201d says <a href=\"https:\/\/www.linkedin.com\/in\/khoedebecke\/\">Kyle Hoedebecke<\/a>, MD, a board-certified physician based in Spring, Texas. \u201cPre-authorization and step therapy are still common practices, with many plans wanting to see documentation of diagnosis, kidney function, or prior medication use.\u201d<\/p>\n<p>Jardiance isn\u2019t covered by Original Medicare (Part A or Part B). You\u2019ll need a standalone Medicare Part D plan or a Medicare Advantage plan that includes prescription drug coverage. Even then, coverage can vary by plan, and some Medicare prescription drug plans may not cover Jardiance at all. Check your plan\u2019s drug formulary to confirm coverage.<\/p>\n<h2 id=\"how-much-does-jardiance-cost-with-medicare\">How much does Jardiance cost with Medicare?<\/h2>\n<p>Price negotiations spurred by the Inflation Reduction Act lowered the 2026 cost of Jardiance by about 66% for Medicare beneficiaries. You\u2019ll pay no more than $197 for a one-month supply of Jardiance, but your plan\u2019s cost-sharing structure likely means you\u2019ll pay significantly less. Your deductible and federal out-of-pocket spending limits can affect the cost of Jardiance, too.<\/p>\n<p>To find out how much Jardiance costs with Medicare, view your plan\u2019s drug formulary and look for the tier number assigned to Jardiance. Drugs are typically sorted into three to five tiers, and higher tier numbers mean higher out-of-pocket costs.<\/p>\n<p>Next, go to your plan\u2019s summary of benefits document. It will list the amount you owe for each drug tier.<\/p>\n<p>Here\u2019s a real example. United Healthcare offers a Medicare Advantage plan with prescription drug coverage. <a href=\"https:\/\/www.uhc.com\/medicare\/alphadog\/AANC26HM0348742_000\">In the plan\u2019s formulary<\/a>, Jardiance is listed as tier 3. According to the plan\u2019s <a href=\"https:\/\/www.uhc.com\/medicare\/health-plans\/details.html\/28604\/011\/H5253105000\/2026\">summary of benefits<\/a>, tier 3 drugs have a coinsurance of 18%. The cost of Jardiance with Medicare was negotiated down to $197 for 30 tablets, so you would owe 18% of that (about $36) at the pharmacy.<\/p>\n<p>But that\u2019s not the full story. You must meet the plan\u2019s deductible before you start paying coinsurance. Medicare Part D deductibles vary but can\u2019t be more than $615 in 2026. When you pay at the pharmacy for a covered prescription, it counts toward your deductible. If Jardiance is the only covered medication you take and you have a deductible of $615, you would need to pay the full $197 cost of Jardiance for about three months before cost-sharing would begin.<\/p>\n<p>The total out-of-pocket spending for all prescriptions covered by Medicare Part D is capped at $2,100 for 2026. After you spend that much on your deductible, copay, and coinsurance, all covered prescriptions cost $0 for the rest of the calendar year.<\/p>\n<h2 id=\"how-to-save-on-jardiance-with-medicare\">How to save on Jardiance with Medicare<\/h2>\n<p>A free SingleCare coupon can help you save money on Jardiance if your Medicare plan doesn\u2019t cover this medication. Other savings programs exist but have stricter eligibility requirements.<\/p>\n<h3 id=\"singlecare-prescription-savings\">SingleCare prescription savings<\/h3>\n<p>With a <a href=\"https:\/\/www.singlecare.com\/prescription-discount-card\">SingleCare prescription discount card<\/a>, you can pay as little as $255 for 30, 25 mg Jardiance tablets at participating pharmacies.<\/p>\n<p>Anyone can use SingleCare regardless of income or insurance status, but you can\u2019t combine this discount card with Medicare. In other words, <a href=\"https:\/\/www.singlecare.com\/prescription\/jardiance\">paying for Jardiance with a SingleCare coupon<\/a> won\u2019t count toward your Medicare deductible or out-of-pocket limit. Thanks to the federally negotiated price, it\u2019s cheaper to use Medicare for Jardiance anyway.<\/p>\n<h3 id=\"medicare-extra-help-low-income-subsidy\">Medicare Extra Help (Low-Income Subsidy)<\/h3>\n<p><a href=\"https:\/\/www.ssa.gov\/medicare\/part-d-extra-help\">Medicare Extra Help<\/a> is a low-income subsidy program that dramatically lowers the cost of prescription drugs for eligible Medicare beneficiaries. To qualify, you must meet income and resource limits.<\/p>\n<p>With Medicare Extra Help, brand-name medications like Jardiance cost $12.65 per prescription, and you no longer have to pay a deductible or monthly premium in most cases<\/p>\n<h3 id=\"boehringer-ingelheim-patient-assistance-program\">Boehringer Ingelheim patient assistance program<\/h3>\n<p>Medicare Part D beneficiaries who don\u2019t qualify for Medicare Extra Help but have an income at or below 250% of the federal poverty level may be able to get Jardiance for free through the <a href=\"https:\/\/www.boehringer-ingelheim.com\/us\/about-us\/sustainable-development\/our-commitment\/pdf\/federal-poverty-guidelines-document\">Boehringer Ingelheim patient assistance program<\/a> (PAP).<\/p>\n<p>The income limit for an individual living in the lower 48 states is $39,900 per year. There are different requirements for Alaska, Hawaii, and larger households.<\/p>\n<p>The Boehringer Ingelheim PAP isn\u2019t the same as the Jardiance savings card. You must have commercial insurance to apply for the Jardiance savings card, so Medicare beneficiaries aren\u2019t eligible.<\/p>\n<h3 id=\"choosing-a-better-medicare-part-d-plan\">Choosing a better Medicare Part D plan<\/h3>\n<p>The cost of Jardiance can vary significantly from plan to plan. Consider shopping around for a new Medicare Part D plan during the Annual Enrollment Period. Some plans offer $0 premiums or $0 deductibles, sort Jardiance into a lower drug tier, or charge more affordable copays and coinsurance. <a href=\"https:\/\/www.medicare.gov\/plan-compare\">Compare plans on Medicare.gov<\/a>.<\/p>\n<h2 id=\"frequently-asked-questions\">Frequently asked questions<\/h2>\n<h3 id=\"is-there-a-generic-for-jardiance\">Is there a generic for Jardiance?<\/h3>\n<p>Not yet. <a href=\"https:\/\/www.singlecare.com\/blog\/jardiance-generic\/\">Generic Jardiance<\/a> isn\u2019t expected until 2029 at the earliest, when the Boehringer Ingelheim patent expires.<\/p>\n<h3 id=\"how-much-will-jardiance-cost-with-medicare\">How much will Jardiance cost with Medicare?<\/h3>\n<p>Jardiance costs vary with Medicare based on your plan\u2019s details and whether you\u2019re enrolled in Extra Help. However, no one with Medicare Part D pays more than $197 for a month\u2019s supply of Jardiance in 2026.<\/p>\n<h3 id=\"what-is-a-cheaper-alternative-to-jardiance\">What is a cheaper alternative to Jardiance?<\/h3>\n<p>Generic <a href=\"https:\/\/www.singlecare.com\/prescription\/farxiga\">Farxiga<\/a> (dapagliflozin) is a cheaper <a href=\"https:\/\/www.singlecare.com\/blog\/jardiance-alternatives\/\">alternative to Jardiance<\/a> that\u2019s in the same drug class. <a href=\"https:\/\/www.singlecare.com\/prescription\/metformin\">Metformin<\/a> is another affordable option to consider.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Jardiance (empagliflozin) is a sodium-glucose co-transporter 2 (SGLT2) inhibitor that\u2019s been approved by the Food and Drug Administration (FDA) to treat Type 2 diabetes in people 10 years and older and to reduce the risk of complications in adults with heart disease or chronic kidney disease. It can be expensive with or without insurance coverage, [&hellip;]<\/p>\n","protected":false},"author":149,"featured_media":628486,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[4343,15],"coauthors":[21074],"class_list":["post-628485","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-brand-name-drugs","tag-medicare","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.0 (Yoast SEO v28.0) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>How much does Jardiance cost with Medicare in 2026?<\/title>\n<meta name=\"description\" content=\"Jardiance cost with Medicare depends on your plan, with monthly costs capped at $197. 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