{"id":630441,"date":"2024-11-14T10:07:09","date_gmt":"2024-11-14T15:07:09","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=630441"},"modified":"2026-01-02T16:38:21","modified_gmt":"2026-01-02T21:38:21","slug":"does-medicaid-cover-farxiga","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-medicaid-cover-farxiga\/","title":{"rendered":"Does Medicaid cover Farxiga?"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/farxiga\"><span style=\"font-weight: 400;\">Farxiga<\/span><\/a><span style=\"font-weight: 400;\"> (dapagliflozin)<\/span><span style=\"font-weight: 400;\"> is a prescription medication used to treat <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/chronic-kidney-disease\/\"><span style=\"font-weight: 400;\">chronic kidney disease<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/farxiga-for-heart-failure\/\"><span style=\"font-weight: 400;\">heart failure,<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/type-2-diabetes-treatment-and-medications\"><span style=\"font-weight: 400;\">Type 2 diabetes<\/span><\/a><span style=\"font-weight: 400;\">. Farxiga helps the kidneys remove glucose from the bloodstream, improving heart and kidney function. Because Farxiga is used to treat chronic conditions, it&#8217;s a long-term treatment, which means the cost can add up over time if you don&#8217;t have insurance.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/farxiga-uses\/\"><b>What is Farxiga used for?<\/b><\/a><\/p>\n<p><span style=\"font-weight: 400;\">The specifics of Medicaid coverage can vary depending on your state. However, the program&#8217;s goal remains to ensure that those who need help the most can access essential healthcare services, including prescriptions and routine medical care. If you are prescribed Farxiga and have Medicaid, you may find that there are limitations to coverage since <\/span><span style=\"font-weight: 400;\">specialty drugs<\/span><span style=\"font-weight: 400;\"> like <a href=\"https:\/\/www.singlecare.com\/prescription\/farxiga\/what-is\">Farxiga<\/a> are more complex and expensive than most prescription medications.<\/span><\/p>\n<h2 id=\"does-medicaid-cover-farxiga\"><span style=\"font-weight: 400;\">Does Medicaid cover Farxiga?\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Medicaid may cover Farxiga, but it depends on the state in which you live. In many states, even if covered, there might be rules about who can get it. For example, some states might only cover it for people with Type 2 diabetes who meet specific criteria.\u00a0<\/span><\/p>\n<h3 id=\"factors-influencing-medicaid-coverage-for-farxiga\"><span style=\"font-weight: 400;\">Factors influencing Medicaid coverage for Farxiga\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If your state&#8217;s Medicaid program covers Farxiga, there might be specific rules you need to follow. These rules can include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">You may need to have a diagnosis of chronic kidney disease, heart failure, or Type 2 diabetes.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Your healthcare provider may need to formally attest to Medicaid that other medications didn&#8217;t work for you. This is called <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/step-therapy\/\"><span style=\"font-weight: 400;\">step therapy<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Your healthcare provider may need to confirm that Farxiga is medically necessary for you. This is called <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/prior-authorization\/\"><span style=\"font-weight: 400;\">prior authorization<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">AstraZeneca, the manufacturer of Farxiga, has a <\/span><a href=\"https:\/\/www.farxiga-hcp.com\/savings-and-access#\"><span style=\"font-weight: 400;\">formulary finder<\/span><\/a><span style=\"font-weight: 400;\"> you can use to see if your state\u2019s Medicaid program covers Farxiga, what tier it assigns Farxiga to, and whether there are any other factors determining coverage.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For example, Wisconsin Medicaid considers Farxiga a tier 2 drug, meaning it is a preferred drug with a \u201cmiddle-level copay.\u201d But it also has <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/quantity-limits\/\"><span style=\"font-weight: 400;\">quantity limits<\/span><\/a><span style=\"font-weight: 400;\">, so Wisconsin Medicaid beneficiaries may have to pay out of pocket for prescriptions that exceed those limits.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In New York, Farxiga is a tier 1 drug, which is the tier that the most affordable drugs are on. Although New York Medicaid doesn\u2019t have quantity limits for Farxiga, it requires step therapy.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">AstraZeneca\u2019s tool may be helpful if you need to know whether Medicaid will cover Farxiga, but coverage can change. It\u2019s best to check your state&#8217;s Medicaid drug list, talk to your healthcare provider, or ask your pharmacist about coverage. They can help you understand what steps you need to take to get it approved.<\/span><\/p>\n<h2 id=\"how-much-does-farxiga-cost\"><span style=\"font-weight: 400;\">How much does Farxiga cost?\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The average <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/farxiga-without-insurance\/\"><span style=\"font-weight: 400;\">cost of Farxiga without insurance<\/span><\/a><span style=\"font-weight: 400;\"> is about $811 for 30, 10 mg tablets. This price is based on the dosage and the pharmacy you visit. You could save on Farxiga by comparing prices at different pharmacies.\u00a0<\/span><\/p>\n<h3 id=\"cost-of-farxiga-with-medicaid\"><span style=\"font-weight: 400;\">Cost of Farxiga with Medicaid<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The amount you&#8217;ll pay for Farxiga with Medicaid depends on which state you live in and what tier Farxiga is on in your state\u2019s Medicaid formulary, among other factors. Medicaid can significantly lower costs, but you might still have to pay a copay.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Your out-of-pocket costs for Farxiga on Medicaid will also depend on whether Farxiga is on your state\u2019s preferred drug list. If it is, you\u2019ll likely pay less than if it were a nonpreferred drug.\u00a0<\/span><\/p>\n<h2 id=\"ways-to-get-discounts-on-farxiga-without-medicaid\"><span style=\"font-weight: 400;\">Ways to get discounts on Farxiga without Medicaid<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">If your state\u2019s Medicaid plan doesn\u2019t cover Farxiga or imposes quantity limits that make it unaffordable, there are other ways to save. One way is to use your <\/span><a href=\"https:\/\/www.singlecare.com\/prescription-discount-card\"><span style=\"font-weight: 400;\">SingleCare prescription discount card<\/span><\/a><span style=\"font-weight: 400;\">. You can use SingleCare to compare the cost of Farxiga at nearby pharmacies and then choose which one you want your healthcare provider to send your prescription to. You can then use a digital coupon to save. For example, you could pay $405 instead of $811 for 30, 10 mg tablets with a <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/farxiga\"><span style=\"font-weight: 400;\">Farxiga coupon<\/span><\/a><span style=\"font-weight: 400;\"> from SingleCare<\/span><span style=\"font-weight: 400;\">. You can use SingleCare coupons if you have Medicaid, but you can\u2019t use both together.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other ways to save on Farxiga without Medicaid include the <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/farxiga-patient-assistance\/\"><span style=\"font-weight: 400;\">Farxiga patient assistance program<\/span><\/a><span style=\"font-weight: 400;\"> and the <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/farxiga-copay-card\/\"><span style=\"font-weight: 400;\">Farxiga copay card<\/span><\/a><span style=\"font-weight: 400;\">. You\u2019re not eligible for either program, though, if you\u2019re enrolled in Medicaid.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have Medicare, keep in mind that you\u2019re dually eligible, meaning <\/span><a href=\"https:\/\/www.medicare.gov\/basics\/costs\/help\/medicaid\"><span style=\"font-weight: 400;\">you may be able to use Medicaid to pay for things that Medicare won&#8217;t<\/span><\/a><span style=\"font-weight: 400;\">. This may or may not be the case for prescription drugs. Starting in 2026,<\/span> <a href=\"https:\/\/www.cms.gov\/priorities\/medicare-prescription-drug-affordability\/overview\/medicare-drug-price-negotiation-program\/selected-drugs-negotiated-prices\"><span style=\"font-weight: 400;\">Medicare will negotiate directly with manufacturers<\/span><\/a><span style=\"font-weight: 400;\"> for the price of specific Medicare Part B and Part D drugs that don&#8217;t have competition, including Farxiga. Until then, if you struggle to afford Farxiga with Medicare, you may qualify for the Part D Low Income Subsidy (LIS) program, also known as<\/span> <a href=\"https:\/\/www.medicare.gov\/basics\/costs\/help\/drug-costs\"><span style=\"font-weight: 400;\">Extra Help<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For the most up-to-date details on Medicaid coverage for Farxiga, consult your healthcare provider and contact your local Medicaid office. Knowing your options can make managing your medication costs easier.<\/span><\/p>\n<p><small><em><span style=\"font-weight: 400;\">The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of Jan. 2, 2026. Prices vary by pharmacy. Visit our <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/farxiga\"><span style=\"font-weight: 400;\">Farxiga coupon page<\/span><\/a><span style=\"font-weight: 400;\"> for updated Farxiga prices near you.<\/span><\/em><small><\/small><\/small><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Farxiga (dapagliflozin) is a prescription medication used to treat chronic kidney disease, heart failure, and Type 2 diabetes. Farxiga helps the kidneys remove glucose from the bloodstream, improving heart and kidney function. Because Farxiga is used to treat chronic conditions, it&#8217;s a long-term treatment, which means the cost can add up over time if you [&hellip;]<\/p>\n","protected":false},"author":149,"featured_media":630442,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[15103,16],"coauthors":[21032],"class_list":["post-630441","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-drug-pricing","tag-medicaid","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Does Medicaid cover Farxiga?<\/title>\n<meta name=\"description\" content=\"Medicaid covers Farxiga in most states, but coverage details depend on where you live, and you may have to try other medications first.\" \/>\n<meta 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