Jardiance is a prescription medication that may be covered under Medicare Part D, but coverage and out-of-pocket costs depend on the specific Medicare drug plan. Medicare Part D plans are offered by private insurers, and each plan maintains its own list of covered prescription drugs, known as a formulary.
Jardiance is the brand name for empagliflozin, a prescription medicine in the sodium-glucose cotransporter-2, or SGLT2, inhibitor class.
The medication is used for certain approved indications involving type 2 diabetes and cardiovascular or kidney-related conditions. The appropriate use depends on the individual's medical circumstances and prescribing information.
A healthcare professional determines whether Jardiance is appropriate for a particular patient.
Medicare Part D can cover Jardiance, but coverage is determined by the individual Part D plan's formulary and coverage rules.
Medicare does not maintain one universal formulary that applies to every Part D plan. Each plan establishes its own list of covered medications within Medicare's requirements.
As a result, one Part D plan may place Jardiance on a different cost-sharing tier or apply different coverage requirements than another plan.
The most reliable way to determine coverage is to check the specific plan's current formulary.
A formulary is the list of prescription medications that a Medicare drug plan covers.
Plans organize covered medications into tiers. Generally, lower tiers have lower cost-sharing requirements, while higher tiers can involve greater copayments or coinsurance. The exact tier structure varies by plan.
When reviewing Jardiance coverage, the formulary can show:
Because formularies can change, checking the current plan information is important.
Medicare beneficiaries can receive prescription-drug coverage through either a standalone Part D plan or a Medicare Advantage plan that includes Part D.
Most Medicare Advantage plans include prescription-drug coverage, although the details differ by plan.
Someone enrolled in Medicare Advantage should therefore check the plan's own formulary rather than assuming that Jardiance coverage is identical across Medicare Advantage plans.
Original Medicare consists of Part A and Part B and generally does not provide routine outpatient prescription-drug coverage.
People with Original Medicare can generally add prescription coverage through a separate Medicare Part D plan.
For an outpatient prescription such as Jardiance, Part D is therefore the part of Medicare that generally needs to be reviewed for coverage.
A Medicare plan may place Jardiance on a particular formulary tier.
Drug tiers are used to determine how much a beneficiary pays for covered medications. Lower tiers generally have lower cost-sharing, while higher tiers may have higher costs.
The tier alone does not determine the final amount paid at the pharmacy.
Other factors can include:
Some Medicare Part D plans use prior authorization for certain prescription drugs.
Prior authorization means the prescriber or patient must obtain approval from the plan before the plan will cover the medication under the applicable circumstances. The plan may require information showing that the medication meets its coverage criteria.
If Jardiance is subject to prior authorization under a particular plan, the prescribing healthcare professional may need to submit supporting information.
Coverage requirements can differ between plans.
Some Part D plans use step therapy.
Under step therapy, a plan may require a person to try another medication before covering a particular drug. Medicare explains that plans can use this type of rule as part of their prescription-drug coverage policies.
If a physician believes that a different medication would be inappropriate or less effective, the patient or prescriber may be able to request an exception under the plan's procedures.
A Medicare drug plan can establish quantity limits for certain medications.
For example, a plan may limit the quantity of a medication that it covers during a specific period.
If a physician believes that a different quantity is medically necessary, an exception may be requested under the plan's rules.
There is no single Medicare price for Jardiance.
The amount paid can vary based on:
Medicare specifically notes that prescription costs can vary according to the drug's formulary status, tier, benefit phase, and pharmacy used.
A plan's current formulary and pharmacy pricing information are therefore more useful than a general national price estimate.
Some Part D plans have a deductible that must be met before the plan begins paying its share for covered prescription drugs.
The amount and structure of the deductible can vary by plan.
After the deductible is satisfied, the beneficiary may pay a copayment or coinsurance according to the plan's cost-sharing structure.
Because Jardiance costs depend on the specific plan, checking the plan's benefit information is important when estimating annual expenses.
For 2026, Medicare has a $2,100 annual out-of-pocket limit for covered Part D prescription drugs.
This limit applies to covered Part D drugs and is distinct from the monthly premium.
Once the applicable annual out-of-pocket limit is reached, the beneficiary generally does not pay additional out-of-pocket costs for covered Part D drugs for the remainder of that calendar year.
The limit does not mean every prescription is free from the beginning of the year.
The pharmacy used to fill Jardiance can affect out-of-pocket costs.
Medicare explains that Part D plans may have preferred in-network pharmacies where members can receive lower cost-sharing than at other pharmacies in the plan's network.
When comparing Jardiance costs, it can therefore be useful to check:
Some Medicare drug plans offer mail-order pharmacy services.
Depending on the plan, mail-order services may provide longer supplies of covered medications, potentially including a 90-day supply.
The specific availability and cost should be confirmed with the plan.
A Medicare Part D plan may not cover a particular prescription medication.
Medicare explains that if a drug is not included on a plan's formulary, there may generally be another covered medication available. In certain circumstances, a patient or prescriber can request an exception.
An exception request may involve documentation from the prescribing professional explaining why the medication is medically necessary.
The plan determines whether the request meets its applicable requirements.
If a plan requires prior authorization, the prescriber may need to submit information to the plan before coverage begins.
The plan can establish criteria related to:
Medicare allows patients and prescribers to request exceptions to certain coverage restrictions when the plan's standard requirements are not appropriate for the individual's medical circumstances.
People comparing Medicare plans should check the medication list before enrolling.
Medicare recommends reviewing a plan's formulary to determine whether the medications taken are covered.
When comparing plans, check:
Medicare provides tools for comparing Medicare drug plans and checking prescription-drug coverage.
The 2026 Medicare & You handbook states that beneficiaries can review a plan's formulary through the plan or use Medicare's plan-comparison resources to determine whether a medication is included.
A useful process is:
Confirm the prescription name, dosage, and quantity.
Find the exact Part D or Medicare Advantage plan.
Search the plan's current drug list for Jardiance.
Look for prior authorization, step therapy, or quantity limits.
Compare preferred and standard in-network pharmacies.
Consider premiums, deductibles, prescription cost-sharing, and other medications.
Medicare offers a Prescription Payment Plan that allows people with Medicare drug coverage to spread covered prescription-drug out-of-pocket costs across the calendar year.
The program does not reduce the total cost of medications. Instead, it changes when the costs are paid.
For someone with substantial prescription costs early in the year, spreading payments may make monthly expenses more predictable.
The program is optional.
Some Medicare beneficiaries may qualify for Extra Help with prescription-drug costs based on their circumstances.
Extra Help can reduce certain Part D costs for qualifying beneficiaries.
Eligibility and benefit amounts are determined under Medicare and Social Security rules.
People who think they may qualify can check the current Medicare requirements.
Medicare Part D formularies are not necessarily permanent.
Medicare states that plans can change their drug lists during the year under applicable rules, including when new medications become available or medical information changes. Plans must notify affected members about applicable changes.
This means that a formulary checked several months earlier may not always reflect the current coverage situation.
Medicare's prescription-drug benefit changed significantly in 2025 and 2026.
For 2026, the annual out-of-pocket limit for covered Part D drugs is $2,100.
Medicare also continues to use negotiated prices for certain selected Part D drugs beginning in 2026. Jardiance should not automatically be assumed to receive a Medicare-negotiated price simply because it is a Part D medication; the applicable drug list and plan rules should be checked.
Before enrolling in or changing a Medicare drug plan, consider asking:
Each plan has its own formulary and cost-sharing structure.
A plan with a lower monthly premium may have different prescription costs or other cost-sharing requirements.
Preferred pharmacies can have different cost-sharing arrangements.
Prior authorization, step therapy, and quantity limits can affect access to a medication.
Plans can make changes to their formularies under Medicare rules.
Part D coverage depends on the specific plan's formulary and applicable rules.
Before selecting or reviewing a plan, check:
Jardiance is listed on the formulary
Correct dosage is covered
Formulary tier
Prior authorization requirements
Step therapy requirements
Quantity limits
Deductible
Copayment or coinsurance
Preferred pharmacies
Mail-order availability
Monthly premium
Other prescription coverage
2026 Part D out-of-pocket limit
Jardiance may be covered by Medicare Part D, but coverage depends on the specific plan's formulary and coverage rules.
No. Part D plans have their own formularies, and the specific tier and restrictions can differ between plans.
Some plans can impose prior authorization or other coverage restrictions on medications. The specific requirements depend on the plan.
There is no universal Medicare price. The amount depends on the plan, formulary tier, deductible, cost-sharing structure, pharmacy, and other factors.
For 2026, the annual out-of-pocket limit for covered Part D prescription drugs is $2,100.
Medicare allows Part D plans to make certain formulary changes during the year under applicable rules. Affected members must receive required notification of changes.
Medicare Part D can provide coverage for prescription medications such as Jardiance, but coverage, formulary tier, restrictions, and out-of-pocket costs depend on the specific Medicare drug plan.
For 2026, beneficiaries should check the current formulary, pharmacy network, deductible, cost-sharing requirements, and any prior-authorization or quantity-limit rules before assuming what Jardiance will cost. Medicare's 2026 prescription-drug benefit also includes a $2,100 annual out-of-pocket limit for covered Part D drugs.