Medicare Coverage for Jardiance: A Look into the Question of Reimbursement
Revised Article:
Getting your mitts on some Jardiance? This med is typically prescribed for heart failure and type 2 diabetes, and a good chunk of it is covered under Medicare Part D. Part C plans with drug coverage should also offer Jardiance, but it all depends on the plan, man.
From June 2022 to May 2023, Medicare parted ways with a sweet $7 billion on Jardiance, with enrollees coughing up an average of $290 out of pocket in 2022. But hey, don't sweat the small stuff - just make sure the med you need is on your plan's formulary.
How much does Jardiance cost on Medicare?
The out-of-pocket pharmacy cost for 30 tablets of Jardiance can range from around $600, but it all boils down to the pharmacy and your plan's specifics. The expense you're left with depends on your insurance plan's tier and your cousbuckids, mate. Oh, and don't forget the monthly premiums for parts C and D - but fret not, those bad boys depend on your chosen plan.
Typically, there's also a deductible you need to hit before coverage kicks in, and for Part D, that can't exceed $590 in 2025. Keep on truckin', and you'll have no trouble reaching that sum. Your total prescription drug spending with Part D has an annual cap of $2,000 too, which should provide some sweet relief.
Glossary of Medicare terms:
- Out-of-pocket cost: The amount you need to stump up when Medicare doesn't cover the total amount or doesn't offer coverage.
- Premium: The monthly dough you drop to keep your Medicare coverage up and running.
- Deductible: An annual amount you've gotta fork over out of your own pocket before Medicare starts picking up the tab.
- Coinsurance: The percentage of the cost you've gotta cover on your own.
- Copayment: A fixed dollar amount you've gotta cough up for certain treatments.
What tier is Jardiance with Medicare?
Every Medicare drug plan may classify Jardiance in a different tier, and the higher the tier, the more costly it'll be after coverage commences. The Inflation Reduction Act of 2022 gave the Secretary of HHS the power to negotiate new prices for Jardiance and a few other meds, making them cheaper for us lowly enrollees.
Is there a cheaper substitute for Jardiance?
As a branded medication, Jardiance doesn't have a generic twin. However, other meds in the SGLT2 inhibitor class, such as Farxiga (dapagliflozin), could be considered alternatives depending on your unique case and insurance coverage.
Financial Assistance Programs
Need some financial aid for some Jardiance? You can slash your expenses with some help from programs like Boehringer Ingelheim's Patient Assistance Program or Rx Outreach. You might even qualify for Medicare Extra Help or State Pharmaceutical Assistance Programs (SPAPs), which vary by state.
Cheaper Substitutes
Since Jardiance is a branded med, it doesn't have a generic counterpart. But don't worry, other meds in the SGLT2 inhibitor class, like Farxiga (dapagliflozin), might be the right fit for you, depending on your specific needs and insurance coverage. Compare prices among different SGLT2 inhibitors to find something more affordable under your plan.
- Although Jardiance is primarily covered under Medicare Part D, the out-of-pocket cost for a 30-tablet supply can range from around $600, depending on the pharmacy and plan specifics.
- The Inflation Reduction Act of 2022 allows the Secretary of HHS to negotiate new prices for Jardiance and some other medications, potentially making them more affordable for Medicare enrollees.
- Since Jardiance doesn't have a generic equivalent, other SGLT2 inhibitors like Farxiga (dapagliflozin) could serve as more cost-effective alternatives, depending on an individual's unique health situation and insurance coverage.
- Financial assistance programs such as Boehringer Ingelheim's Patient Assistance Program, Rx Outreach, Medicare Extra Help, and State Pharmaceutical Assistance Programs (SPAPs) can help enrollees reduce their Jardiance expenses.
- To find a cheaper SGLT2 inhibitor, compare prices among various options in the SGLT2 inhibitor class and choose the one that offers the best price under your specific Medicare plan.
