Does Medicare cover Jardiance and Farxiga (SGLT2 inhibitors)?

Yes — Medicare Part D covers Jardiance (empagliflozin), Farxiga (dapagliflozin), Steglatro (ertugliflozin), and Invokana (canagliflozin). These SGLT2 inhibitors are widely covered for FDA-approved indications (Type 2 diabetes, heart failure, chronic kidney disease) but tier placement and copay vary significantly by plan.

FDA-approved indications now include (covered by Medicare):

• Type 2 diabetes (original indication)
• Heart failure with reduced ejection fraction (HFrEF)
• Heart failure with preserved ejection fraction (HFpEF) — Jardiance and Farxiga
• Chronic kidney disease (CKD) — Jardiance and Farxiga
• Reducing cardiovascular risk in T2D patients with established CVD

This broad indication list means most patients who'd benefit from SGLT2 inhibitors qualify for Medicare coverage. Even patients without diabetes can get coverage if they have heart failure or CKD.

Typical 2026 Part D coverage:

• Jardiance: Most plans Tier 3. Retail $620–$700/month; typical copay $45–$200/month.
• Farxiga: Most plans Tier 3. Retail $580–$650/month; typical copay $40–$180/month.
• Invokana: Tier 3 on most plans, declining market share due to amputation risk warnings.
• Steglatro: Tier 3 typical; less commonly prescribed than Jardiance/Farxiga.

Prior authorization requirements:

Most plans require PA before approving SGLT2 inhibitors. Documentation typically includes:
- The qualifying diagnosis (T2D, HFrEF, HFpEF, CKD, or established CVD)
- For T2D: HbA1c data or treatment history
- For HF: ejection fraction data
- For CKD: eGFR and/or albuminuria documentation

Approval is typically straightforward when documentation is provided.

Step therapy considerations:

Some plans require trying older diabetes drugs (metformin, sulfonylureas) before SGLT2. Many plans have removed step therapy for SGLT2 inhibitors given their cardiovascular and renal benefits — but verify your specific plan's policy.

The 2026 $2,000 cap impact:

For a member on Jardiance at $150/month copay:
- Annual drug spend without cap: $1,800 + potential catastrophic phase = $2,000–$3,000
- With 2026 cap: $2,000 maximum, then $0 rest of year
- Members on Jardiance + other expensive drugs hit the cap faster

Side-by-side: Jardiance vs Farxiga:

Clinically very similar; both shown to reduce cardiovascular events and slow CKD progression. Differences:
- Jardiance has slightly more cardiovascular evidence
- Farxiga has earlier CKD approval timing
- Farxiga can be slightly cheaper at retail in some markets
- Plan formularies often prefer one over the other on Tier 2 vs Tier 3 — check yours

Selection strategy:

1. Confirm your indication is covered. With expanded approvals, most patients qualify. PA verifies clinical fit.

1. Check tier placement on Part D plans. Significant cost variance — Jardiance might be Tier 2 on Plan A and Tier 4 on Plan B in the same ZIP.

1. Bundle with other medications. If you're on multiple expensive drugs (Eliquis, GLP-1s, statins, etc.), the $2,000 cap means total spend matters more than individual drug copays.

1. Manufacturer assistance: Boehringer Ingelheim/Lilly (Jardiance) and AstraZeneca (Farxiga) have patient assistance programs but federal anti-kickback rules limit Medicare beneficiary participation.

Notable limitations:

• Diabetic ketoacidosis risk requires monitoring
• Genitourinary infections more common
• Dehydration risk in some patients
• Not appropriate for type 1 diabetes

What to do next: [Look up your full drug list across every Part D plan in your ZIP](/tools/drug-pricing/) or call (866) 534-1886 — we run your specific medications including SGLT2 inhibitors against every plan's formulary and total your projected annual cost. Free.