Is Jardiance Medicare-covered?
Medicare's popular prescription drug, Jardiance, costs the average Medicare Part D enrollee approximately $290 out of pocket in 2022. Unfortunately, specific numbers for 2023 aren't publicly available. The cost varies depending on the plan, tier, and individual requirements like deductibles or copays[1].
Jardiance is a medication that can help manage heart failure and type 2 diabetes. Most Medicare Part D plans offer coverage for this drug, as do Part C plans with drug coverage. However, remember that coverage depends on your selected plan.
The cost of Jardenze at a pharmacy can exceed $600 for 30 tablets, but the amount you'll actually pay depends on your insurance plan and the drug's tier. You'll also have monthly premiums for Part C and D, with Part D's deductible not exceeding $590 in 2025 and an annual drug spending cap of $2,000[2].
What's the deal with these Medicare terms?
- Out-of-pocket cost: This is the amount you pay when Medicare doesn't cover the entire cost or provide coverage. This may include deductibles, coinsurance, copayments, and premiums.
- Premium: This is the monthly amount you pay for Medicare coverage.
- Deductible: This is an amount you must pay out of pocket annually before Medicare covers your treatments.
- Coinsurance: This is the percentage of treatment costs you'll cover. For Medicare Part B, coinsurance is 20%.
- Copayment: This is a fixed amount you pay for certain treatments, and it usually applies to prescription drugs for Medicare.
What tier is Jardiance in with Medicare?
Each Medicare drug plan can place Jardiance in a different tier, and the higher the tier, the pricier it becomes after coverage kicks in. The Inflation Reduction Act of 2022 empowers the Secretary of Health and Human Services (HHS) to negotiate new prices for Jardiance and several other drugs[3].
How can I get Jardiance for free or at a lower cost?
You can lower Jardiance's expenses through various financial assistance programs, such as Medicaid, Extra Help, and State Pharmaceutical Assistance Programs (SPAPs)[4].
Is there a cheaper alternative to Jardiance?
Currently, Jardiance doesn't have a generic version.
Jardiance falls under the category of called SGLT2 inhibitors. These drugs function in the kidneys to eliminate excess sugar from the body via urine. Jardiance may benefit the heart and kidneys. Whether your plan covers Jardiance or other heart disease drugs or diabetes drugs depends on the specifics of your plan[5]. Examples of diabetes drugs that plans might cover include metformin, nateglinide, acarbose, and glyburide[5].
You should know that Original Medicare's Part B may cover certain drugs, such as IV medications, typically administered by a healthcare professional and not self-administered[5].
[1] Source: Medicare.gov
[2] Source: Medicare.gov
[3] Source: https://www.hhs.gov/inflation-reduction-act/ faqs/ inflation-reduction-act-faqs#question-12
[4] Source: https://www.healthcare.gov/ drug-cost-help/
[5] Source: Medicare.gov and WebMD
- The cost of Jardiance, a drug used to manage heart failure and type 2 diabetes, varies based on the Medicare Part D plan, the drug's tier, and individual requirements like deductibles or copays.
- Out-of-pocket cost is the amount you pay when Medicare doesn't cover the entire cost or provide coverage, and includes deductibles, coinsurance, copayments, and premiums.
- Jardiance is usually covered by Medicare Part D plans, as well as Part C plans with drug coverage, but coverage depends on your selected plan.
- To get Jardiance for free or at a lower cost, you can explore financial assistance programs such as Medicaid, Extra Help, and State Pharmaceutical Assistance Programs (SPAPs).
- As of now, there is no generic version of Jardiance, but other diabetes drugs like metformin, nateglinide, acarbose, and glyburide might be covered by your Medicare plan depending on its specifics.
