Medicare Coverage for Jardiance: A Review
Salute there, buddy! Let's dive into the dollars and cents of Jardiance, a medication that helps with heart failure and type 2 diabetes. Most Medicare Part D plans cover this baby, but Part C plans with drug coverage may as well, depending on your lucky star.
Now, from June 2022 to May 2023, ol' Medicare dropped a chunky $7 billion on Jardiance, with enrollees forking out an average of $290 in 2022 (oops, I mean last year).
You might be wondering, "How much does this cost me, dude?" Well, it's like this. According to Optum Perks, one slab of 30 tablets of Jardiance tends to ring up around $600, give or take a few bucks depending on where you're filling the prescription. With different insurance plans and tiers, your outlay could vary. Darn those private insurers and their constantly changing premiums!
Usually, you'll also encounter deductibles, coinsurance, copays, and that ever-lovin' premium. But don't kick yourself, partner. Medicare Part D's deductible can't wiggle higher than $590 in 2025, and there's a cap on your total Spending on any drug with Part D at $2,000 per year. Ain't that a relief?
Glossary of Medicare terms:
- Out-of-pocket cost: That's the amount you shell out of your pocket when Medicare doesn't foot the whole bill or offer coverage.
- Premium: That's the monthly bribe you pay for your Medicare coverage.
- Deductible: That's an annual amount you gotta scrape together before Medicare comes knocking on the door to help with your treatments.
- Coinsurance: That's the percentage of the costs you must foot yourself. With Medicare Part B, it's a cool 20%.
- Copayment: That's a fixed dollar amount you cough up when you pick up your prescriptions with insurance.
Jardiance's tier, eh?
Oh, each Medicare drug plan might stick Jardiance in a different tier, and a higher tier can make it sting more when coverage kicks in.
The Inflation Reduction Act of 2022 has become the FBI's newest frenemy in town. This bad boy allowed the Secretary of Health and Human Services (HHS) to negotiate fresh prices for Jardiance and a few others, making 'em more affordable for us, the mob.
Can I score Jardiance for free?
Heck yes! You can nimbly lower your Jardiance expenses by participating in various financial assistance programs, like Medicaid, Extra Help, or State Pharmaceutical Assistance Programs (SPAPs). These bad boys can help you with drug costs, trials, and premiums.
A cheaper Jardiance sub?
Unfortunately, Jardiance ain't available in a generic version yet, cowboy.
Other diabetes or heart disease medications under Medicare:
Jardiance belongs to the SGLT2 inhibitors gang, a bunch of drugs that stir up some trouble in the kidneys to help expel extra sugar from the bod through pee. Jardiance can kick your heart and kidneys into gear, but whether or not your plan covers Jardiance or other heart disease drugs depends on the specific very-cautiously-named plan. Similarly, coverage for diabetes medications like metformin, nateglinide, acarbose, and glyburide may vary depending on the plan.
Jardiance and Original Medicare's Part B:
Original Medicare's Part B may offer coverage for certain drugs, like IV medications that you, my dude, can't give yourself a darn shot of.
- The Inflation Reduction Act of 2022 allows the Secretary of Health and Human Services to negotiate lower prices for medicines like Jardiance, aiming to make them more affordable.
- By participating in financial assistance programs such as Medicaid, Extra Help, or State Pharmaceutical Assistance Programs (SPAPs), you can potentially lower your Jardiance expenses and reduce drug costs, trials, and premiums.
- Unlike Jardiance, other medications used for diabetes or heart disease may have varying coverages depending on the Medicare plan, as their availability and coverage depend on the specific plans.
