{"id":633040,"date":"2025-08-05T17:02:11","date_gmt":"2025-08-05T21:02:11","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=633040"},"modified":"2025-08-05T17:04:51","modified_gmt":"2025-08-05T21:04:51","slug":"does-aetna-cover-jardiance","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-aetna-cover-jardiance\/","title":{"rendered":"Does Aetna cover Jardiance?"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/jardiance\"><span style=\"font-weight: 400;\">Jardiance<\/span><\/a><span style=\"font-weight: 400;\"> (empagliflozin) is a brand-name drug that\u2019s approved by the Food and Drug Administration to lower blood sugar levels in people 10 years and older with <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/diabetes-causes\"><span style=\"font-weight: 400;\">Type 2 diabetes mellitus<\/span><\/a><span style=\"font-weight: 400;\">, to reduce the risk of dying of heart disease in adults diagnosed with <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/jardiance-for-heart-failure-how-it-works-effectiveness-more\/\"><span style=\"font-weight: 400;\">heart failure<\/span><\/a><span style=\"font-weight: 400;\"> or Type 2 diabetes, and to reduce certain health risks in people with chronic kidney disease. Jardiance is typically covered by insurance, but coverage varies from plan to plan.\u00a0<\/span><\/p>\n<h2 id=\"does-aetna-cover-jardiance\"><span style=\"font-weight: 400;\">Does Aetna cover Jardiance?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Prescription drug coverage varies by plan, and some Aetna plans don\u2019t offer drug coverage at all. However, when drug coverage is provided, Aetna typically covers Jardiance for Medicare, commercial, and marketplace plans. Medicaid coverage varies by state.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/synergyhouses.com\/staff\/\"><span style=\"font-weight: 400;\">James Lyons<\/span><\/a><span style=\"font-weight: 400;\">, a physician and medical consultant for Synergy Houses in West Chester, Pennsylvania, confirms that \u201cin most cases, Aetna does cover Jardiance, mainly when it is <\/span><a href=\"https:\/\/patient.boehringer-ingelheim.com\/us\/products\/jardiance\/bipdf\/prescribing-information-isi\"><span style=\"font-weight: 400;\">prescribed for conditions like Type 2 diabetes with cardiovascular risk, heart failure, or chronic kidney disease<\/span><\/a><span style=\"font-weight: 400;\">. It is well-studied in these areas and has real benefits in terms of reducing hospitalization and protecting kidney function.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Here\u2019s what you can usually expect from an Aetna health insurance plan:<\/span><\/p>\n<ul>\n<li aria-level=\"1\"><b>Commercial and marketplace insurance: <\/b><span style=\"font-weight: 400;\">Jardiance tends to be <\/span><a href=\"https:\/\/fm.formularynavigator.com\/FBO\/41\/2025_Aetna_Standard_Plan.pdf\"><span style=\"font-weight: 400;\">covered as a preferred brand<\/span><\/a><span style=\"font-weight: 400;\"> (PB).<\/span><\/li>\n<li aria-level=\"1\"><b>Medicare Advantage or Part D: <\/b><span style=\"font-weight: 400;\">Aetna classifies Jardiance as a Tier 3 drug and limits the amount you can get to 30 tablets per 30 days. These Aetna plans allow Jardiance to be delivered via mail order.\u00a0<\/span><\/li>\n<\/ul>\n<p>Jardiance typically requires <a href=\"https:\/\/www.singlecare.com\/blog\/prior-authorization\/\">prior authorization<\/a>, which means Aetna will review your medical history before agreeing to cover the cost of this prescription. If Aetna refuses to cover Jardiance, your healthcare provider can appeal on your behalf. They typically need to submit a letter explaining why Jardiance is necessary for your treatment and why alternatives aren\u2019t appropriate.\u00a0<b><\/b><\/p>\n<p><span style=\"font-weight: 400;\">\u201cI have seen some hiccups with prior authorizations,\u201d Dr. Lyons says. \u201cIt usually comes down to how the diagnosis is documented. For example, if the paperwork does not indicate that the patient meets the criteria, such as having established cardiovascular disease or reduced kidney function, the initial request may be denied. However, when we submit supporting records or lab results, we\u2019re typically able to get it approved on appeal.\u201d<\/span><\/p>\n<p><a href=\"https:\/\/fm.formularynavigator.com\/FBO\/41\/2025_New_Jersey_Educators_Health_Plan.pdf\"><span style=\"font-weight: 400;\">Some Aetna plans<\/span><\/a><span style=\"font-weight: 400;\"> require <\/span><a href=\"https:\/\/steptherapy.com\/what-is-step-therapy\/\"><span style=\"font-weight: 400;\">step therapy<\/span><\/a><span style=\"font-weight: 400;\"> before the insurance company will approve a prescription for Jardiance. This means you must try a different (and typically more affordable) prescription first, and that Aetna will only approve your Jardiance prescription if the first medication didn\u2019t work or caused unwanted side effects.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to Aetna\u2019s <\/span><a href=\"https:\/\/www.aetna.com\/products\/rxnonmedicare\/data\/2023\/Antidiabetic_Agents_ST,_Post_PA_Policy_676-D_UDR_05-2023_v2.html\"><span style=\"font-weight: 400;\">coverage criteria<\/span><\/a><span style=\"font-weight: 400;\">, people with Type 2 diabetes must try <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/metformin-hcl\"><span style=\"font-weight: 400;\">metformin<\/span><\/a><span style=\"font-weight: 400;\"> before Jardiance. Aetna doesn\u2019t require Jardiance step therapy for people diagnosed with heart failure or chronic kidney disease.\u00a0<\/span><\/p>\n<h2 id=\"how-much-does-jardiance-cost-without-insurance\"><span style=\"font-weight: 400;\">How much does Jardiance cost without insurance?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Without insurance, Jardiance costs an average of $870 for 30, 25 mg tablets. Jardiance is one of the most expensive <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/sglt2-inhibitors\"><span style=\"font-weight: 400;\">sodium-glucose cotransporter 2 (SGLT2) inhibitors<\/span><\/a><span style=\"font-weight: 400;\">, but not by much. Most SGLT2 inhibitors cost over $800 for a 30-day supply without insurance.\u00a0<\/span><\/p>\n<h2 id=\"how-much-does-jardiance-cost-with-aetna\"><span style=\"font-weight: 400;\">How much does Jardiance cost with Aetna?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Copays and coinsurance vary by plan, but many <\/span><a href=\"https:\/\/www.aetna.com\/content\/dam\/aetna\/pdfs\/aetnacvshealthcom\/2025-IFP-774721_58840TX0110103-01_SBC.pdf\"><span style=\"font-weight: 400;\">Aetna plans<\/span><\/a><span style=\"font-weight: 400;\"> charge about $50 for a 30-day supply of a preferred brand drug like Jardiance. A 90-day supply has a copay of about $125. If your plan allows you to get Jardiance via mail-order, a 90-day supply is usually sent.<\/span><\/p>\n<h2 id=\"how-to-check-whether-your-aetna-plan-covers-jardiance\"><span style=\"font-weight: 400;\">How to check whether your Aetna plan covers Jardiance\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There are several ways to check whether your specific Aetna plan covers Jardiance:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Look at the formulary<\/b><span style=\"font-weight: 400;\"> (also called the drug list). You may have received a printed version of this document. It should have an index to help you easily find the page with coverage details for Jardiance.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Log in to your online Aetna account<\/b><span style=\"font-weight: 400;\">, if you have one. Here, you can view a digital copy of your plan\u2019s <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-a-formulary\/\"><span style=\"font-weight: 400;\">formulary<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Call the customer service number<\/b><span style=\"font-weight: 400;\"> on the back of your Aetna health insurance card. A company representative can look up your plan and tell you whether Jardiance is covered.<\/span><\/li>\n<\/ul>\n<h2 id=\"how-to-save-on-jardiance\"><span style=\"font-weight: 400;\">How to save on Jardiance<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">If your Aetna plan doesn\u2019t cover Jardiance, you aren\u2019t stuck paying its full retail price. And even if you do have insurance coverage for Jardiance, there are ways to lower your out-of-pocket costs.<\/span><\/p>\n<h3 id=\"1-sign-up-for-a-free-singlecare-card\"><span style=\"font-weight: 400;\">1. Sign up for a free SingleCare card<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A <\/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;\"> is absolutely free to use and could save you close to $350. Depending on your choice of pharmacy, you could pay about $528 for 30, 25 mg tablets of Jardiance with a SingleCare coupon if Aetna doesn\u2019t cover it. Type Jardiance in the search bar, enter your ZIP code, and compare discounted prices at pharmacies near you. Select which pharmacy you want to go to and click \u201c<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/jardiance\"><span style=\"font-weight: 400;\">Get Coupon<\/span><\/a><span style=\"font-weight: 400;\">.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">From here, you can save the coupon to your free SingleCare account, print it, or text or email it to yourself. Show the printed or digital coupon to your pharmacist when you pick up your Jardiance prescription. Don\u2019t forget to tell your healthcare provider where to send the prescription if your usual pharmacy doesn\u2019t have the lowest price.\u00a0<\/span><\/p>\n<h3 id=\"2-see-if-you-re-eligible-for-the-manufacturer-s-savings-program\"><span style=\"font-weight: 400;\">2. See if you\u2019re eligible for the manufacturer\u2019s savings program<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Boehringer Ingelheim, the manufacturer of Jardiance, offers a savings program for people with commercial insurance (not Medicare or Medicaid, for example) who pay a copay or coinsurance fee for the medication. If you qualify, you could pay as little as $10 for a 30-day or 90-day supply of Jardiance. Eligibility guidelines disqualify a significant number of people.<\/span><\/p>\n<h3 id=\"3-enroll-in-the-medicare-extra-help-program\"><span style=\"font-weight: 400;\">3. Enroll in the Medicare Extra Help program<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The Medicare <\/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;\"> program reduces the out-of-pocket drug costs for Medicare recipients who meet certain income requirements. If you qualify for Extra Help, you could pay up to $12.15 for name-brand prescriptions like Jardiance.<\/span><\/p>\n<h3 id=\"4-consider-a-90-day-supply\"><span style=\"font-weight: 400;\">4. Consider a 90-day supply<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If your Aetna insurance plan doesn\u2019t limit the quantity of <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/jardiance\/dosage\"><span style=\"font-weight: 400;\">Jardiance tablets<\/span><\/a><span style=\"font-weight: 400;\"> you can receive at each refill, consider getting a 90-day supply rather than a 30-day supply. The 90-day copay may be less expensive than paying the 30-day copay three times.<\/span><\/p>\n<h3 id=\"5-consider-an-alternative-drug-treatment\"><span style=\"font-weight: 400;\">5. Consider an alternative drug treatment<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If your Aetna plan doesn\u2019t cover Jardiance, or if your copay or coinsurance is too high, talk to your healthcare provider. They may be able to recommend more affordable <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/jardiance-alternatives\/\"><span style=\"font-weight: 400;\">Jardiance alternatives<\/span><\/a><span style=\"font-weight: 400;\">, such as drugs in other classes that work in different ways to treat your condition.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Jardiance (empagliflozin) is a brand-name drug that\u2019s approved by the Food and Drug Administration to lower blood sugar levels in people 10 years and older with Type 2 diabetes mellitus, to reduce the risk of dying of heart disease in adults diagnosed with heart failure or Type 2 diabetes, and to reduce certain health risks [&hellip;]<\/p>\n","protected":false},"author":149,"featured_media":633041,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[10298,608,737],"coauthors":[21074],"class_list":["post-633040","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-diabetes","tag-health-insurance","tag-heart-health","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.0 (Yoast SEO v27.0) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Does Aetna cover Jardiance?<\/title>\n<meta name=\"description\" content=\"Aetna covers Jardiance in many cases, but coverage varies by plan. 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