Medicare Coverage for Jardiance: An Examination
Surething! Let's take a smokin' shot at rewriting this Medicare breakdown on Jardiance, making it cooler, clearer, and less drug-trip-y.
Jump on the Jardiance Wagon with Medicare: A Breakdown
You might've heard about Jardiance, the med that doctors prescribe to treat type 2 diabetes and heart failure. Good news: most Medicare Part D prescriptions and Part C plans that come with drug coverage have got your back when it comes to Jardiance. Here's a lowdown on what you can expect to shell out.
2022-2023 Spendage on Jardiance
From June 2022 to May 2023, Medicare plowed $7 billion into Jardiance, with an average Joe coughing up around $290 out of pocket back in 2022.
Every drug under Medicare comes with its own list of covered meds, called a formulary. To get Jardiance covered, you gotta join a prescription drug plan that includes it in their formulary mix.
"YOU KNOW WHAT YOU OWE"
Let's talk costs. According to Optum Perks, the out-of-pocket cost for a month's stash (30 tabs) of Jardiance runs around $600, depending on your pharmacy.
The exact amount you'll pay depends on your insurance plan, whether Jardiance falls on a high tier, and your plan's premium, coinsurance, copayment, and any deductibles.
"SKIM THE CREAM OFF THE TOP"
Typically, there's an annual deductible to meet before Medicare kicks in, but no worries — the max deductible for Part D in 2025 is capped at $590. Also, your total spending for prescription drugs with Part D has an annual cap of $2,000.
GLoSSaRY OF MEDicARE TERMS
- Out-of-pocket cost: Amount you pay for care when Medicare doesn't cover the entirety or offers limited coverage.
- Premium: Monthly payment for Medicare coverage.
- Deductible: Annual amount you must shell out before Medicare starts covering your treatments.
- Coinsurance: Fraction of treatment cost you must cover yourself.
- Copayment: Fixed amount you pay for certain treatments.
"THE TIER'S THE THING"
Every Medicare drug plan might place Jardiance in a different tier. The higher the tier, the pricier Jardiance could be for ya after coverage kicks in.
The Inflation Reduction Act of 2022 gave the Secretary of Health and Human Services the power to negotiate new, lower prices for Jardiance, making it cheaper for enrollees.
"GET IT FOR FREE? SORTA!"
If you wanna lower your expenses, you can opt for financial assistance programs like Medicaid, Extra Help, or State Pharmaceutical Assistance Programs (SPAPs).
"CHEAPER SUBSTITUTE? NOT SO FAST!"
Unfortunately, Jardiance isn't available as a generic version yet.
"LOOKING FOR SOMETHIN' ELSE?
Jardiance is a type of drug called SGLT2 inhibitors. These meds help your kidneys remove excess sugar from your body via pee. Jardiance might help your heart and kidneys. Whether a plan covers Jardiance or any other heart disease or diabetes drugs depends on the specific plan. Examples of meds for diabetes that plans may cover include metformin, nateglinide, acarbose, glyburide, and more.
Looking for more info on diabetes meds and Medicare? Check this out: [[ diabetes medications and Medicare ]]
Looking for more info on heart disease medication coverage? Check this out: [[ Does Medicare cover cardiovascular disease? ]]
- Medicare has invested approximately $7 billion in Jardiance for the period of June 2022 to May 2023, with the average enrollee paying around $290 out of pocket in 2022.
- To get Jardiance covered under Medicare, one must join a prescription drug plan that includes it in their formulary.
- The out-of-pocket cost for a month's supply of Jardiance can range around $600, depending on the pharmacy and insurance plan.
- The Inflation Reduction Act of 2022 provides the Secretary of Health and Human Services with the authority to negotiate new, lower prices for Jardiance, potentially making it cheaper for enrollees.
- Financial assistance programs such as Medicaid, Extra Help, or State Pharmaceutical Assistance Programs (SPAPs) can help lower expenses for those seeking to purchase Jardiance under Medicare.
