Question: Is Jardiance covered by Medicare?
Rewritten Article:
Jardiance is a popular med for heart failure and type 2 diabetes, often prescribed by docs. Most Medicare Part D drug plans offer coverage for Jardiance, with Part C plans that include drug coverage following suit - though it depends on the specific plan.
From June 2022 to May 2023, Medicare spent a whopping $7 billion on Jardiance, with enrollees averaging just over $290 out-of-pocket in 2022.
Every medication that Medicare covers comes with a formulary, a list of drugs the plan covers. To get coverage for Jardiance, you gotta enroll in a druggist plan that includes Jardiance in its formulary.
How much does Jardiance cost on Medicare?
To give you a ballpark figure, it's a ballsy $600 for 30 tablets of Jardiance, but this varies by pharmacy. The exact amount you'll pay depends on your insurance plan, the drug's tier, and the coinsurance required. Apart from the coinsurance, you'll have to pay a monthly premium for Part C and D, with the rate depending on your plan.
Typically, there's a deductible you gotta meet before coverage kicks in. For Part D, this can't exceed $590 in 2025. Also, your total drug spending on Part D has a yearly cap of $2,000.
Know Your Medicare Terms:
- Out-of-Pocket Cost: Money you have to fork over for care yourself, since Medicare doesn't cover everything. This can include deductibles, copayments, premiums, and more.
- Premium: Money you shell out each month for Medicare coverage.
- Deductible: Amount you gotta shell out yourself before Medicare starts covering costs.
- Coinsurance: Percentage of treatment costs you gotta pay yourself. For Medicare Part B, this is 20%.
- Copayment: Fixed dollar amount you pay for certain treatments when you have insurance. This usually applies to prescription drugs.
Tier for Jardiance:
Each Medicare druggist plan can put Jardiance in a different tier, with higher tiers meaning higher costs for you after the coverage kicks in.
Thanks to the Inflation Reduction Act of 2022, the Secretary of Health and Human Services (HHS) can now negotiate new prices for Jardiance and nine other drugs, making them more affordable for enrollees.
Free Jardiance?
Keep costs down by leveraging financial aid programs like Medicaid, Extra Help, and State Pharmaceutical Assistance Programs (SPAPs).
Cheaper Alternatives?
Generic drugs are usually cheaper than brand-name drugs, but unfortunately, Jardiance isn't available in a generic form.
Other Diabetes or Heart Disease Medications:
Jardiance belongs to the SGLT2 inhibitor class, working in the kidneys to eliminate excess sugar via urine. Besides Jardiance, other heart disease drugs and diabetes drugs that plans may cover include:
- metformin (Glumetza)
- nateglinide (Starlix)
- acarbose (Precose)
- glyburide (DiaBeta, Micronase, Glynase)
Remember, Original Medicare's Part B may cover certain IV medications that you can't administer yourself.
For more info, check out these resources:
- Learning more about what makes up the Medicare drug list
- How to get cheaper medications for diabetes
- Information on drugs for heart disease coverage under Medicare.
[1] Based on enrichment data provided for one plan. Your actual costs may vary based on your plan's cost-sharing structure and the regional prices of the pharmacy where you fill your prescriptions.[2] You can learn more about this topic here.[3] You can read more about this topic here.[4] You can access the drug cost estimator tool here.
- The cost for Jardiance can vary, with an estimated $600 for 30 tablets, but it significantly depends on the specific Medicare Part D plan, the drug's tier, and the coinsurance required.
- Medicare Part D has a yearly cap on total drug spending, which cannot exceed $2,000 in 2023.
- Due to the Inflation Reduction Act of 2022, the Secretary of Health and Human Services has the authorization to negotiate new, more affordable prices for Jardiance and other selected drugs.
