Table of Contents
I. Jardiance: A Quick Overview
II. Is Jardiance Covered by Medicare?
III. How Much Does Jardiance Cost with Medicare?
IV. The Cost of Jardiance with Medicare: Putting it All Together
Jardiance is one of the leading medications for people dealing with diabetes management. But, as with any long-term prescription medication, one of the top concerns for new patients is its cost. And for older patients, one of the first questions they ask is: How much does Jardiance cost with Medicare?
It can seem daunting to figure out given the number and complexity of many Medicare plans. In this guide, we’ll give you the straightforward information you need to figure out just how much Jardiance will cost with your current Medicare plan.
Quick Takeaways:
- Jardiance controls blood sugar levels for people with type 2 diabetes, and can also treat cardiovascular and kidney conditions.
- It is covered by Medicare Part D and Medicare Advantage plans.
- To determine how much Jardiance costs with your Medicare plan, you need to find it on the drug formulary and determine the cost by including your plan’s premiums, deductibles, and copays.
- Even with Medicare, Jardiance can cost hundreds of dollars out-of-pocket each year.
- Canadian online pharmacies like My Drug Center offer safe, affordable alternatives to save money on Jardiance and other prescriptions.
Jardiance: A Quick Overview
Jardiance, also known by its generic name empagliflozin, is a once-daily oral medication revolutionizing diabetes management. It’s an SGLT2 inhibitor, designed to control blood sugar levels for individuals with Type 2 diabetes.
What distinguishes Jardiance from other diabetes medications is its unique mechanism of action and its potential to deliver multifaceted benefits. Here’s how it works:
Ordinarily, the kidneys filter glucose (sugar) from the bloodstream and then subsequently reabsorb it, returning it to the body. In individuals with type 2 diabetes, this process is often compromised, leading to elevated blood sugar levels.
Jardiance intervenes by inhibiting the action of a protein called SGLT2 within the kidneys. This inhibition prevents the reabsorption of glucose and encourages its elimination through urine, thereby effectively reducing blood sugar levels.
In addition to regulating blood sugar levels, Jardiance can also reduce the risk of cardiovascular events such as heart attacks and strokes among people with type 2 diabetes, making it an especially invaluable option for people who have pre-existing heart conditions or elevated risk to develop them.
Most recently, Jardiance was also FDA-approved for people dealing with chronic kidney disease (CKD). [2]
Is Jardiance Covered by Medicare?
Yes, Jardiance is covered by Medicare—but not by all plans. To ensure your Jardiance prescription is covered, you need to know the different Medicare plans, how they differ, and what they cover. Here’s a quick summary:
Medicare Part A (hospital coverage) and Part B (medical coverage) do not cover prescription drugs. To get Jardiance covered by Medicare, you must be enrolled in Medicare Part D or a Medicare Advantage Plan that also includes prescription drug coverage.
Fortunately for Medicare beneficiaries, there are plenty of plans to choose from, so you likely won’t have trouble finding one that works for you. Medicare Part D and Medicare Advantage together offer 50+ plan options that include prescription coverage. [3]
Fortunately, Medicare beneficiaries have options when it comes to prescription drug coverage. In 2022, they had more than 50 plans to choose from between Part D and Medicare Advantage. [3]
How Much Does Jardiance Cost with Medicare?
To understand how much Jardiance costs with Medicare, there are a few things you’ll need to know about and research:
Medicare Part D or Medicare Advantage Drug Formulary
First, you’ll want to look at your plan's drug formulary.
A drug formulary is a list of prescription medications that a healthcare plan or insurance provider covers and makes available to its members. Medications on the formulary are typically categorized into tiers that each have different cost-sharing requirements for the beneficiary.
Drug tiers do vary by insurance provider but often follow the following general categorization method:
- Tier 1: Generic drugs
- Tier 2: Preferred brand-name drugs
- Tier 3: Non-preferred brand-name drugs
- Tier 4: Specialty drugs
Jardiance is categorized as Tier 3 in most Medicare Part D formularies. According to their website, this means it’s listed as: “higher copayment: non-preferred, brand-name prescription drugs.” [5]
Monthly Premiums, Deductibles, and Co-Insurance
Once you know the formulary, there are three types of insurance costs to be familiar with as you determine how much your Jardiance will cost with Medicare.
1. Monthly premiums are regular payments that Medicare beneficiaries are required to make in order to maintain their coverage. These payments can vary depending on the specific type of Medicare plan.
Part D premiums are paid either directly to Medicare or the private insurance company administering their plan. Medicare Advantage plans may have their own premium structures. Premiums help fund the overall Medicare program and ensure that beneficiaries have access to necessary healthcare services.
2. Deductibles represent the initial out-of-pocket costs that beneficiaries must pay before their Medicare coverage kicks in. Medicare Part D’s most recent update outlined a maximum initial deductible of $505 before Medicare begins covering Jardiance (or any other drugs). [6]
3. Copays and Coinsurance
After you’ve reached your annual deductible, your Medicare Part D or Medicare Advantage plan will pay for most of your Jardiance prescription costs. You’ll be responsible for paying your copay, which is usually less than $20 per month.
Keep in mind that after you’ve spent $4,660 in combined covered drug costs, you’ll pay up to 25% of your prescription drug total cost. While it’s uncommon for people to reach this phase, which is called the coverage gap, it can happen—especially when people take multiple medications.
The Cost of Jardiance with Medicare: Putting it All Together
The good news is that Jardiance is covered by Medicare Part D and Medicare Advantage plans. But the reality is that given monthly premiums for Part D plans, plus deductibles and copays, people covered by Medicare plans often still pay hundreds or even thousands of dollars for their needed medications.
If that has been your experience, it’s important to know that there are other options. Canadian online pharmacies have become a trusted option for people burdened with high prescription drug costs. They offer prescription drugs at a significantly lower retail price than in the U.S.
Plus, they offer quick and convenient delivery options that can make managing your medications easier.
My Drug Center is a leading online Canadian pharmacy saving customers up to 80% on prescription drugs each year. Lean more here about how to save on your next Jardiance prescription.
The information in the article is not meant to be used for treatment or diagnosis. It is designed for general awareness and for information purposes only. Always consult a medical professional for your specific healthcare needs.
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