{"id":634150,"date":"2025-11-04T10:21:56","date_gmt":"2025-11-04T15:21:56","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=634150"},"modified":"2025-11-04T10:21:56","modified_gmt":"2025-11-04T15:21:56","slug":"does-aetna-cover-farxiga","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-aetna-cover-farxiga\/","title":{"rendered":"Does Aetna cover Farxiga?"},"content":{"rendered":"

Farxiga<\/span><\/a> is a brand-name prescription drug used to treat Type 2 diabetes, heart failure, and chronic kidney disease. The active ingredient is dapagliflozin, which belongs to a class of drugs called <\/span>SGLT2 inhibitors<\/span><\/a>. It works by helping the kidneys clear extra sugar from the body through the urine. While Farxiga can improve blood sugar and heart health, it comes at a cost. Most health insurance plans cover Farxiga, but out-of-pocket expenses can vary.<\/span><\/p>\n

Does Aetna cover Farxiga?<\/span><\/h2>\n

Aetna typically covers Farxiga when it\u2019s prescribed for an approved use. There are different types of Aetna plans with prescription drug coverage. Although coverage varies, Farxiga is considered a preferred drug on most Aetna formularies (covered drug lists).\u00a0<\/span><\/p>\n

For example, the 2025 formulary for the <\/span>Aetna Standard Plan<\/span><\/a> shows Farxiga as a preferred brand name, with both the 5-mg and 10-mg tablets covered. However, <\/span>generic dapagliflozin<\/span><\/a> is currently non-formulary, meaning it\u2019s not covered unless the plan makes an exception.\u00a0<\/span><\/p>\n

Aetna <\/span>Medicare<\/span><\/a> plans usually list Farxiga on their formularies. On the 2025 Medicare drug list, Farxiga is placed on <\/span>Tier 2<\/span><\/a>, which means it\u2019s a preferred brand-name drug with moderate copays. Coverage is capped at 30 tablets per month, or one pill a day.<\/span><\/p>\n

When it comes to Medicaid, Farxiga or its generic version may be covered, but with stricter guidelines. For example, patients may need to meet <\/span>certain clinical criteria<\/span><\/a>, such as trying <\/span>metformin<\/span><\/a> first or having risk factors for heart disease. In any case, it\u2019s best to check the plan\u2019s drug list or contact Aetna directly for more information.<\/span><\/p>\n

How much is Farxiga without insurance?<\/span><\/h2>\n

Without insurance<\/span><\/a>, the average retail price of Farxiga is $823 for 30, 10 mg tablets. The price may be higher or lower, depending on the quantity prescribed and the pharmacy you visit. Those without insurance can look for different savings options, such as a SingleCare discount card, that could help lower the retail price.<\/span><\/p>\n

\t\t

\n\t\t\t

Save up to 80% on Farxiga with SingleCare<\/p>\n\t\t\t

Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.<\/p>\n\t\t\t

\n\t\t\t\t
\n\t\t\t\t\tFarxiga 10 mg (30 tablets)\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t23663 - Hampton, VA\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t
\n\t\t\t\"Food\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t$40.70\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
\n\t\t\t
\n\t\t\t\"CVS\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t$207.43\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\tSee Farxiga prices at all pharmacies<\/a>\n\t\t<\/div>\n\n\t\t<\/span><\/p>\n

How much does Farxiga cost with Aetna?<\/span><\/h2>\n

The cost of Farxiga with Aetna will vary based on the plan and what tier the drug is on. Aetna usually places Farxiga on <\/span>Tier 2 or 3<\/span><\/a> of its drug lists. Tier 2 medications generally have lower copays than Tier 3 drugs.<\/span><\/p>\n

According to Farxiga\u2019s manufacturer, <\/span>AstraZeneca<\/span><\/a>, the average copay for Farxiga with an employer or individual private plan is around $26 per month. For those with government-provided insurance plans like Medicare and Medicaid, the costs can differ. With Medicare Part D coverage, the average cost of Farxiga is almost $39 per month. The cost with Medicaid varies by state.\u00a0<\/span><\/p>\n

Prescription drug costs can depend on whether you’ve met your annual deductible. Some members pay full price until reaching their deductible amount.<\/span><\/p>\n

How to check whether your Aetna plan covers Farxiga\u00a0<\/span><\/h2>\n

The easiest way to check Farxiga coverage is through Aetna’s online tools. Members can visit Aetna’s medication search page to find their specific drug list and coverage details. To sign in online, you\u2019ll typically need your Aetna ID card with member information. The online drug search tool on Aetna may also show specific coverage information, such as whether <\/span>prior authorization<\/span><\/a> or <\/span>step therapy<\/span><\/a> rules are in place.\u00a0\u00a0<\/span><\/p>\n

Aetna members can also call the customer service number on their ID card. Representatives can provide more information about which prescription drugs are covered and the specific requirements a plan may have.<\/span><\/p>\n

In addition, the manufacturer\u2019s website may provide ways to verify whether a specific insurance plan covers the drug. They often offer resources to understand drug coverage before visiting the pharmacy.\u00a0<\/span><\/p>\n

Keep in mind that while a generic version exists, it may have different coverage rules than brand-name Farxiga.<\/span><\/p>\n

How to save on Farxiga<\/span><\/h2>\n

Farxiga can be hard to access for some. However, there are different ways to potentially lower the cost, such as discount cards, shopping around, and assistance programs. These options may help when insurance coverage isn\u2019t enough.<\/span><\/p>\n

Use a SingleCare discount card<\/span><\/h3>\n

SingleCare offers a <\/span>free discount card<\/span><\/a> that may help lower Farxiga prescription costs at many pharmacies across the U.S.. Download and show the card to the pharmacy when filling a Farxiga prescription to save up to 80% per month. You can also use the <\/span>SingleCare app<\/span><\/a>. The card can’t be combined with insurance copay benefits, so it\u2019s best to compare the SingleCare price with your insurance copay to see which option costs less.\u00a0<\/span><\/p>\n

Compare prices at pharmacies<\/span><\/h3>\n

The cost of Farxiga may be different at one pharmacy than another. That\u2019s because large chain pharmacies, independent pharmacies, and online pharmacies often have different pricing details. If you\u2019re willing to shop around, you might have better chances of finding a good price. An online tool like the <\/span>SingleCare<\/span><\/a> drug search tool can pool prices from different pharmacies in one place.\u00a0<\/span><\/p>\n

Check for patient assistance programs<\/span><\/h3>\n

The Farxiga manufacturer may have savings programs for eligible patients. These programs could help reduce monthly copay costs to as low as $0 for those who meet the income requirements and other eligibility criteria. Apply directly through the manufacturer’s website or ask your healthcare provider for assistance.\u00a0<\/span><\/p>\n

Purchase a larger quantity<\/span><\/h3>\n

Getting a <\/span>90-day supply<\/span><\/a> instead of a 30-day supply may help reduce the per-dose cost of Farxiga. Many insurance plans offer lower copays for larger quantities of medicine. Check whether your insurance plan covers 90-day supplies. Some plans may cover a larger quantity if you use their pharmacy network.<\/span><\/p>\n

If your insurance plan won\u2019t cover Farxiga, or you find the out-of-pocket costs too high, you can always speak with your healthcare provider about other options. <\/span>Alternatives to Farxiga<\/span><\/a> are available, sometimes as a generic that could be more accessible.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Farxiga is a brand-name prescription drug used to treat Type 2 diabetes, heart failure, and chronic kidney disease. The active ingredient is dapagliflozin, which belongs to a class of drugs called SGLT2 inhibitors. It works by helping the kidneys clear extra sugar from the body through the urine. While Farxiga can improve blood sugar and […]<\/p>\n","protected":false},"author":149,"featured_media":634151,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[10298,608],"coauthors":[8669],"class_list":["post-634150","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-diabetes","tag-health-insurance","wpautop"],"acf":[],"yoast_head":"\nDoes Aetna cover Farxiga?<\/title>\n<meta name=\"description\" content=\"Aetna typically covers Farxiga when it\u2019s prescribed for an approved use, but coverage varies by plan, and you may have to reach your deductible first.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.singlecare.com\/blog\/does-aetna-cover-farxiga\/\" \/>\n<meta property=\"og:locale\" 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