Medicare and Jardiance: Is coverage applicable?
Wanna Know About Jardiance on Medicare? Here's the Lowdown
Jardiance is a popular med for heart failure, type 2 diabetes, and other health issues. Most Medicare Part D drug plans got you covered, but it depends on your plan. For Part C and D, coverage can vary.
From June 2022 to May 2023, Medicare spent a whopping $7 billion on ol' Jardiance, with enrollees shelling out an average of $290 out of pocket in 2022.
Got a druggy list called a formulary? Every med on Medicare has one. To get Jardiance covered, you gotta sign up for a plan that includes it.
So, How Much Does Jardiance Cost?
According to Optum Perks, a 30-day supply could set you back around $600 at the pharmacy. But remember, the amount you'll pay out-of-pocket depends on your plan. And you still gotta cough up a monthly premium for parts C and D. Premiums change depending on your plan.
Typically, there's also a deductible you gotta meet before Medicare chips in. For Part D, this year's deductible can't exceed $590. Also, your total spending for any drugs with Part D has a yearly cap of $2,000.
Let's Break it Down:
- Out-of-pocket Cost: The amount you pay for care when Medicare doesn't foot the full bill. Can include deductibles, coinsurance, copayments, and premiums.
- Premium: The amount you pay each month for Medicare coverage.
- Deductible: An annual amount you have to spend out of pocket before Medicare kicks in.
- Coinsurance: The portion of treatment costs you have to cover. For Medicare Part B, it's 20%.
- Copayment: A fixed fee you pay when receiving treatments, usually applies to prescription drugs.
What's Jardiance's Tier?
Every plan may place Jardiance in a different tier, and the higher the tier, the more you'll likely pay after coverage kicks in. The 2022 Inflation Reduction Act even allowed the Secretary of Health and Human Services (HHS) to negotiate new prices for Jardiance and nine other drugs.
Need some financial aid for Jardiance? Try Medicaid, Extra Help, and State Pharmaceutical Assistance Programs (SPAPs).
No generic Jardiance? That's a bummer. But there may be cheaper alternatives. Keep an eye out for heart disease and diabetes drugs in the SGLT2 inhibitor class, like metformin, nateglinide, acarbose, glyburide, and others that your plan might cover.
Remember, a little legwork can help you save cash on Jardiance. Research plans, look for financial assistance programs, and chat with your healthcare provider. It's all part of the game!
[1] This amount is an estimate and can vary between pharmacies and plans.[2] Average 2025 Medicare cost estimates.
- Jardiance falls under Medicare Part D, which covers most prescription drugs, though coverage can depend on your specific plan.
- The average out-of-pocket cost for Jardiance in 2022 was approximately $290, but this can vary significantly depending on the plan and pharmacy.
- The cost of a 30-day supply of Jardiance at a pharmacy is around $600, though your actual out-of-pocket cost will also be influenced by your plan's tiers and any potential discounts.
- Deductibles for Medicare Part D plans can't exceed $590 annually, and there's a yearly cap of $2,000 on total out-of-pocket spending for drugs covered under Part D.
- To reduce the cost of Jardiance, consider exploring financial aid options such as Medicaid, Extra Help, and State Pharmaceutical Assistance Programs (SPAPs).
- If no generic version of Jardiance is available, look for cheaper alternatives within the SGLT2 inhibitor class, such as metformin, nateglinide, acarbose, glyburide, and others, as your plan may cover these medications.
