Mooning Over the Medicare Expenses: All About Jardiance
Medicare Coverage for Jardiance: An Examination
Jardiance is a med your doc might prescribe for managing heart failure and type 2 diabetes. Most Medicare Part D prescription drug plans offer coverage for this little wonder. But, like any insurance, it's about the plan you're in.
From June 2022 to May 2023, Medicare shelled out a whopping $7 billion for Jardiance, with the typical enrollee forking over $290 out of pocket in 2022.
Every medication under Medicare has a formulary, a list of covered treatments. To get on board, you need to sign up for a prescription drug plan that includes Jardiance.
How Much Does Jardiance Cost You Under Medicare?
According to Optum Perks, the out-of-pocket cost for a monthly supply of Jardiance pills can come up to around $600, depending on where you pick them up. The exact cost you'll pay depends on your insurance plan's tier for this drug and any additional coinsurance or premiums.
Expect to see some additional costs, like monthly premiums and deductibles. Deductibles can be as high as $590 in 2025 for Part D, and there's an annual cap of $2,000 on out-of-pocket costs for drugs in this plan.
Key Terms for Medicare Junkies:
- Out-of-pocket cost: The amount you pay for treatment when Medicare doesn't cover the total cost or doesn't offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.
- Premium: The monthly amount you pay for Medicare coverage.
- Deductible: The amount you must spend out of pocket during a certain period before Medicare starts paying for treatments.
- Coinsurance: The percentage of treatment costs you must cover.
- Copayment: A fixed amount you pay for certain treatments. For Medicare, this typically applies to prescription drugs.
Jardiance's Tier on the Medicare Dancefloor
Every Medicare plan might place Jardiance in a different tier, and a higher tier means it could be more expensive once coverage kicks in. But, thanks to the Inflation Reduction Act of 2022, the Secretary of Health and Human Services (HHS) now has the power to negotiate new prices for Jardiance and nine other drugs, making them more budget-friendly for enrollees.
Free Favor Pro: Cutting Down Jardiance Costs
There are a few ways to lower your expenses on Jardiance. These include:
- Medicaid
- Extra Help
- State Pharmaceutical Assistance Programs (SPAPs)
A Cheaper Alternative for Jardiance: Finding Fortune's Favorite
Since Jardiance doesn't have a generic version, expect to pay more compared to some other medications.
Diabetes and Heart Meds Under Medicare's Umbrella
Jardiance is part of the SGLT2 inhibitor crew, a family of drugs that works in the kidneys to eliminate excess sugar from the body through urine. These meds might help your heart and kidneys. Whether your plan covers Jardiance or any other heart disease drug depends on your specific plan. The same goes for medications for diabetes. Some examples of diabetes treatments your plan may cover include:
- metformin (Glumetza)
- nateglinide (Starlix)
- acarbose (Precose)
- glyburide (DiaBeta, Micronase, Glynase)
Be in the know: Original Medicare's Part B may cover certain drugs, like IV medications, which are typically medications you can't administer yourself.
[1] Data Reference 1
[2] Data Reference 2
- The Medicare Part D prescription drug expenses for Jardiance in the fiscal year 2022-2023 totaled approximately $7 billion, with an average out-of-pocket cost of $290 per enrollee.
- Under Medicare, the cost of Jardiance can vary depending on the drug's tier in the plan, the insurance's premiums, deductibles, coinsurance, and copayments, and state-specific health systems like Medicaid, Extra Help, or State Pharmaceutical Assistance Programs (SPAPs) may provide assistance.
- As part of the Medicare coverage, Jardiance falls under the category of SGLT2 inhibitors, a class of medications that aid in eliminating excess sugar from the body through urine, along with other drugs like metformin, nateglinide, acarbose, and glyburide for diabetes treatment and certain IV medications for heart disease under Original Medicare's Part B.
