Does Humana Cover Jardiance?
The verdict
Covered on most plans
Yes — Humana covers Jardiance for type 2 diabetes, heart failure, and CKD across Medicare Part D and its other lines, typically as a Tier 3 preferred brand. Medicare prior authorization and step therapy are remarkably low for Jardiance: nationally 0% PA and only 0.1% step therapy (MMIT, as of Aug 8, 2025). As a Part D sponsor, Humana must apply the IRA negotiated Maximum Fair Price of $197 per 30-day supply, effective January 1, 2026. Boehringer Ingelheim reports that approximately 84% of Medicare Part D patients pay $0–$50 per month (manufacturer-reported average — not a guarantee). The $2,100 annual Part D cap is the safety net.
Coverage is set by your specific plan and formulary. This is a research summary — always confirm with Humana using your member ID.
Key facts
Jardiance has the lowest Medicare prior-authorization rate among SGLT2 inhibitors: 0% of Medicare Part D plans nationally require PA and only 0.1% require step therapy (MMIT, as of Aug 8, 2025).
MMIT via GoodRx (as of Aug 8, 2025)
The 2026 IRA Maximum Fair Price for Jardiance is $197 per 30-day supply — a 66% reduction from the prior list price of approximately $573; all Humana Part D plans must apply this price.
CMS Medicare Drug Price Negotiation Program, 2026 MFP
Boehringer Ingelheim reports approximately 84% of Medicare Part D patients pay $0–$50 per month for Jardiance (manufacturer-reported average, not guaranteed). CenterWell, Humana's preferred mail-order pharmacy, typically provides the lowest available cost tier.
Boehringer Ingelheim Jardiance patient support; Humana plan benefit documents
Medicare vs. commercial coverage
Whether Humana covers Jardiance depends heavily on which kind of plan you hold. They follow completely different rules — here's each one, side by side.
Medicare
Part D & Advantage plans
Jardiance is covered on Humana's 2026 Medicare Part D plans, typically as a Tier 3 preferred brand. Prior authorization and step therapy on Medicare are remarkably low for Jardiance: nationally 0% of Medicare Part D plans require PA and only 0.1% require step therapy (MMIT, as of Aug 8, 2025). As a Part D sponsor, Humana must apply the IRA negotiated Maximum Fair Price of $197 per 30-day supply, effective January 1, 2026 — a 66% reduction from the prior list price of approximately $573. Boehringer Ingelheim reports that approximately 84% of Medicare Part D patients pay $0–$50 per month for Jardiance and roughly 16% average about $166; these are manufacturer-reported averages, not guaranteed cost-shares for any specific Humana plan. The 2026 Part D $2,100 annual out-of-pocket cap limits total exposure. Note: the coinsurance-shift caveat applies — the MFP is a payer-side ceiling, and your actual cost depends on whether your specific Humana plan uses a fixed copay or coinsurance. Using CenterWell, Humana's preferred mail-order pharmacy, typically results in lower cost-sharing. LIS/Extra Help enrollees pay $0–$12.65 per month. Medicare beneficiaries cannot use the Boehringer Ingelheim commercial savings card.
Commercial / Employer
Group & marketplace plans
Humana's commercial and ACA footprints are limited relative to its Medicare Part D operations. Where Humana commercial or ACA plans are offered, Jardiance is covered for its on-label indications — nationally 99.7% of commercial plans and 99.9% of ACA plans cover it (MMIT, Aug 8, 2025). Commercial step therapy is the critical nuance: nationally 38.9% of commercial plans require a metformin-first step for Jardiance and 3.4% require prior authorization (MMIT, Aug 8, 2025). If a Humana commercial plan requires step therapy, your prescriber should document prior metformin use at the maximum tolerated dose or a clinical contraindication. Humana Medicaid MCOs cover Jardiance with nominal cost-share ($0–$10 typical); prior authorization and metformin-first step therapy are common in Medicaid (nationally 25.5% PA, 22.9% step — MMIT, Aug 8, 2025). Verify your state's Preferred Drug List. The Boehringer Ingelheim savings card (~$10 per fill) is available for commercially insured patients not enrolled in a government program. No generic empagliflozin is currently available.
The 3 boxes you must tick to get approved
Commercial plans that will consider Jardiance require prior authorization. Check off what applies to you to see how close you are — this is a guide, not a guarantee of approval.
Meet all 3 and you have a documented case for approval. Missing any one is the most common reason requests are denied.
Your cost, three ways
What Jardiance actually costs you swings enormously depending on how it's covered. Here's the realistic range.
Paying cash
Approximately $600 or more per 30-day supply at retail pharmacy for brand Jardiance (pharmacy-variable estimate). No generic empagliflozin is currently available.
List price with no coverage — before any manufacturer savings card.
With coverage
Medicare Part D (Humana): Tier 3 cost-share; IRA Maximum Fair Price $197 per 30-day supply effective January 1, 2026; approximately 84% of Part D patients pay $0–$50 per month (Boehringer Ingelheim, manufacturer-reported average — not guaranteed); $2,100 annual out-of-pocket cap; LIS/Extra Help $0–$12.65 per month. Medicaid: $0–$10 typical. Commercial: Boehringer Ingelheim savings card ~$10 per fill (commercially insured, non-government patients). All figures are estimates — verify with your specific Humana plan.
Typical monthly copay once prior authorization is approved.
All dollar figures are estimates. Your actual cost depends on your specific Humana plan's tier structure, deductible status, and benefit phase. The Boehringer Ingelheim $0–$50 Part D cost band is a manufacturer-reported average — not a guarantee for any specific plan. The MFP of $197 is a payer-side ceiling — your copay depends on whether Humana's plan uses a fixed copay or coinsurance. Using CenterWell mail-order typically results in lower cost-sharing. Medicare beneficiaries cannot use the Boehringer Ingelheim commercial savings card.
Check YOUR exact coverage in 3 steps
General answers only get you so far. Here's how to confirm your own plan's decision in a few minutes.
- 1
Look up Jardiance on the Humana plan formulary tool
Visit Humana.com and use the drug pricing or formulary search for your 2026 plan. Search for Jardiance or empagliflozin to confirm the tier, any prior authorization or step-therapy requirement, and your estimated cost-share. Also consider asking your pharmacist about generic dapagliflozin (Farxiga's generic, now available) as an SGLT2 alternative if cost is a concern. Confirm whether your plan uses a fixed copay or coinsurance for the Tier 3 preferred brand.
- 2
Ask your prescriber to document metformin history if on commercial or Medicaid
If you are on a Humana commercial or Medicaid plan, a metformin-first step-therapy requirement is common for Jardiance. Ask your prescriber to document prior metformin use (dose, duration, and reason for stopping or contraindication) with the prescription to satisfy the step-therapy requirement. This is the standard evidence needed to resolve most coverage requests.
- 3
Use CenterWell or call Humana member services to confirm your cost
CenterWell is Humana's preferred mail-order pharmacy and typically offers the lowest cost-sharing for Part D enrollees. Call the number on the back of your Humana ID card and ask: (1) Which tier is Jardiance on my plan? (2) Is prior authorization or step therapy required? (3) Has my annual deductible been met? (4) Does my plan use a fixed copay or coinsurance for Tier 3 drugs? Have your plan ID and Jardiance dosage (10 mg or 25 mg) ready.
Options if Humana won't cover Jardiance
A denial isn't the end of the road. These are the paths people commonly explore next — discuss any of them with your prescriber.
Farxiga (dapagliflozin) or generic dapagliflozin
Farxiga is another SGLT2 inhibitor for T2D, heart failure, and CKD. Generic dapagliflozin is already available and may offer a lower tier cost-share than brand Jardiance on Humana plans. The 2026 IRA negotiated price for Farxiga is $178.50 per 30-day supply. Discuss with your prescriber whether dapagliflozin or empagliflozin better fits your clinical needs.
Januvia (sitagliptin) or generic sitagliptin
A DPP-4 inhibitor for type 2 diabetes. Generic sitagliptin launched May 2026 (Sandoz), offering significantly lower cost. The 2026 IRA negotiated price for Januvia is $113 per 30-day supply. DPP-4s lack the cardiovascular/kidney benefits of SGLT2s — discuss clinical fit with your prescriber.
Metformin (generic)
First-line oral diabetes medication; Tier 1 at approximately $4 per month cash price. If step therapy requires metformin first, your prescriber will document this before approving Jardiance.
These options are listed for information only — your own clinician decides what is appropriate for you.
❓Frequently Asked Questions
Yes — Humana covers Jardiance for type 2 diabetes, heart failure, and CKD on its 2026 Medicare Part D plans and other lines, typically as a Tier 3 preferred brand with essentially zero prior authorization (0% PA, 0.1% step nationally — MMIT, Aug 8, 2025). On commercial and Medicaid plans, metformin-first step therapy is common. The 2026 IRA negotiated price is $197 per 30-day supply. Boehringer Ingelheim reports approximately 84% of Part D patients pay $0–$50 per month (manufacturer-reported).
CMS negotiated a Jardiance Maximum Fair Price of $197 per 30-day supply, effective January 1, 2026 — a 66% reduction from the prior list price of approximately $573. All Humana Part D plans must apply this price. However, the MFP is a payer-side ceiling — your actual copay depends on your plan's tier structure and whether Humana uses a fixed copay or coinsurance. The $2,100 annual Part D out-of-pocket cap limits your worst-case exposure.
Boehringer Ingelheim reports that approximately 84% of Medicare Part D patients pay $0–$50 per month for Jardiance and roughly 16% average about $166; these are manufacturer-reported averages, not guarantees for your specific Humana plan. Your actual cost depends on your plan's tier, deductible status, and whether it uses a fixed copay or coinsurance under the $197 IRA negotiated price. The $2,100 annual Part D cap is your backstop. Use CenterWell, Humana's mail-order pharmacy, for the best cost-sharing tier.
On Humana Medicare Part D, a metformin-first step is not expected — nationally 0% of Medicare plans require PA and 0.1% require step therapy for Jardiance (MMIT, Aug 8, 2025). On Humana commercial or Medicaid plans, metformin-first step therapy is common (38.9% of commercial plans, 22.9% of Medicaid plans nationally). If step therapy is required, your prescriber should document prior metformin use or a contraindication. Verify your specific Humana plan.
Only if you have a Humana commercial plan — not Medicare or Medicaid. The Boehringer Ingelheim savings card (~$10 per fill) is available for commercially insured patients not enrolled in any government health program. If you have Humana Medicare Part D, Medicare Advantage, or Humana Medicaid, you cannot use the savings card. LIS/Extra Help enrollees may pay $0–$12.65 per month through the federal subsidy program instead.
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Read moreThis content is for informational purposes only and does not constitute medical, financial, or insurance advice. Coverage rules, prior-authorization criteria, and copay amounts change frequently and vary by plan, formulary tier, and effective date — always verify current benefits directly with Humana before making any decision. Consult a licensed healthcare provider and your plan administrator for guidance specific to your situation.