Drug CostSeptember 6, 2026·9 min read·By Jacob Posner, Founder & Editor
SGLT2 Cost on Medicare 2026: Jardiance vs Farxiga vs Generic Dapagliflozin
Medicare Part D enrollees in 2026 face three distinct SGLT2 inhibitor price paths. Jardiance (empagliflozin) has a federally negotiated Maximum Fair Price of $197 for a 30-day supply under the Inflation Reduction Act, with no generic on the market. Farxiga (dapagliflozin) has its own Maximum Fair Price of $178.50, but a generic version of dapagliflozin has been on pharmacy shelves since April 2026 and frequently costs less than the brand's negotiated price once a plan's generic formulary tier and Extra Help copay rules apply. This guide breaks down what each option actually costs a Medicare beneficiary in 2026, when the generic beats the negotiated brand price, and how to apply for manufacturer assistance if your plan still charges too much.
Quick Answer: In 2026, Medicare Part D enrollees pay a Maximum Fair Price of $197 per 30-day supply for Jardiance and $178.50 for brand Farxiga, both negotiated under the Inflation Reduction Act and effective January 1, 2026. Generic dapagliflozin, FDA-approved April 7, 2026, is not subject to the IRA negotiation itself but is typically placed on a plan's lowest generic formulary tier, so many Part D enrollees pay less for the generic than the negotiated Farxiga brand price, and enrollees with Extra Help (Low-Income Subsidy) pay as little as $1.60 to $5.10 per fill for the generic in 2026. Jardiance has no generic and is not expected to have one until roughly 2028 to 2030. All three options fall under the 2026 Part D annual out-of-pocket cap of $2,100. Boehringer Ingelheim's BI Cares program and AstraZeneca's Farxiga savings and patient support programs offer additional help for patients who still cannot afford their copay.
Jardiance (empagliflozin, Boehringer Ingelheim and Eli Lilly), Farxiga (dapagliflozin, AstraZeneca), and generic dapagliflozin are the three cost paths most relevant to a Medicare Part D enrollee choosing an SGLT2 inhibitor in 2026. All three are once-daily oral tablets approved for type 2 diabetes, and Jardiance and Farxiga both carry expanded FDA approvals for heart failure and chronic kidney disease. This page focuses on the Medicare-specific cost comparison between the two IRA-negotiated brands and the new generic option. Readers who also want Invokana (canagliflozin) in the comparison, which was not selected for Medicare price negotiation, should see the broader SGLT2 cost comparison page.
Medicare's Inflation Reduction Act price negotiation program (Public Law 117-169, signed August 16, 2022) selected both Jardiance and Farxiga among the first 10 drugs negotiated, with Maximum Fair Prices effective January 1, 2026. Generic dapagliflozin entered the market separately on April 7, 2026, when the FDA approved the first generic versions from multiple manufacturers. Because a generic is a different National Drug Code than the brand, it is not covered by Farxiga's negotiated Maximum Fair Price; instead, each Medicare Part D plan places it on its own generic formulary tier, which typically carries a lower flat copay than either negotiated brand price. Jardiance remains brand-only with no generic competitor expected before roughly 2028 to 2030, so its $197 Maximum Fair Price is the best price a Medicare enrollee can currently get for empagliflozin.
CoveredUSA's Medicare-focused SGLT2 comparison covers Part D formulary tier placement, Extra Help (Low-Income Subsidy) copay amounts, cash retail and GoodRx pharmacy pricing, manufacturer patient assistance programs, and what to do if a Part D plan denies coverage or overcharges above the Maximum Fair Price. Patients unsure whether they qualify for Medicaid should check the Medicaid income limits guide, and beneficiaries confirming their Medicare enrollment status should review Medicare eligibility. For a full dollar breakdown by pharmacy for each individual drug, see the dedicated pages for Jardiance and Farxiga.
What SGLT2 Cost on Medicare 2026 Costs by Point of Pay (2026)
The price you pay depends almost entirely on WHERE you pay. The same sglt2 cost on medicare 2026 can cost many times more at a hospital than at your local pharmacy:
2026 SGLT2 Cost on Medicare 2026 Price by Point of Pay
Where you pay
Typical cost
Notes
Pharmacy counter (retail cash, no insurance)
$180 - $831/month
Generic dapagliflozin $180-$220; brand Farxiga $360-$778; brand Jardiance $255-$831, all as full 2026 cash price for a 30-day supply, varying by pharmacy and coupon
Medicare Part D, brand (2026 IRA Maximum Fair Price)
Federally mandated Maximum Fair Prices effective 2026-01-01; the plan cannot charge more, and the $2,100 annual Part D out-of-pocket cap applies to both
Medicare Part D, generic dapagliflozin
$0 - $20/month standard; $1.60 - $5.10 with Extra Help
Placed on the plan's lowest generic formulary tier; not subject to the Farxiga Maximum Fair Price since it is a separate NDC; often cheaper than either negotiated brand price
Commercial insurance with manufacturer savings card
$0 - $10/month
Jardiance and Farxiga manufacturer coupon cards cap copays at $0-$10/month for commercially insured patients only; not valid with Medicare or Medicaid
Medicaid
$1 - $4/prescription
Covered in most states for all three options; prior authorization is common for brand Jardiance and brand Farxiga when the generic is preferred on the state formulary
Medicare Maximum Fair Prices per the CMS IRA negotiation announcement effective January 1, 2026. Extra Help (Low-Income Subsidy) copays for 2026 are $1.60 generic and $4.90 brand for enrollees at or below 100 percent of the federal poverty level, and $5.10 generic and $12.65 brand for enrollees between 100 and 150 percent of FPL. Once total out-of-pocket spending reaches the $2,100 cap in a calendar year, covered drugs cost $0 for the rest of the year.
Source: CMS IRA Negotiated Prices 2026, CMS Medicare Part D 2026 Extra Help copay schedule, GoodRx, SingleCare
Why Hospitals Charge So Much
Jardiance, brand Farxiga, and generic dapagliflozin are self-administered oral tablets dispensed mainly through retail pharmacies, so inpatient hospital billing for any of the three is uncommon. Medicare Part A typically bundles a continued home medication into the DRG (Diagnosis-Related Group) payment for the hospital stay rather than billing it as a separate pharmacy line item, so most Medicare beneficiaries will not see a distinct SGLT2 inhibitor charge on an inpatient bill.
Hospital chargemasters that do list an SGLT2 inhibitor as a separate line item typically price it at 1.5 to 3 times the drug's acquisition cost, producing charges of $500 to $1,800 for a supply that cost the hospital $200 to $600 to acquire. Medicare beneficiaries who see any SGLT2 inhibitor billed separately on an itemized inpatient bill should request the National Drug Code and compare it against the hospital's CMS-mandated price transparency file.
Medicare's clinical guidance for all three options is identical on one point: CMS and diabetes society guidelines recommend stopping any SGLT2 inhibitor, brand or generic, before surgery, prolonged fasting, or contrast-dye procedures because of the risk of euglycemic diabetic ketoacidosis. A hospitalized Medicare beneficiary may legitimately have the drug held during a surgical admission, and should verify the medication reconciliation note before disputing any missing dose on the bill.
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Boehringer Ingelheim and AstraZeneca each run a patient assistance program and a commercial savings card for their brand SGLT2 inhibitor. Because generic dapagliflozin already carries a low cash price and a low Part D generic tier copay, most patients on the generic do not need a formal patient assistance program. Manufacturer coupon cards are for commercially insured patients only; none can be used by anyone on Medicare, Medicaid, TRICARE, or VA benefits under federal anti-kickback law.
Patient assistance programs for SGLT2 Cost on Medicare 2026
Manufacturer program
Cost / Benefit
How to apply
BI Cares Patient Assistance Program (Boehringer Ingelheim, Jardiance)
Free Jardiance (up to 90-day supply) for uninsured or underinsured patients, including some Medicare enrollees, who meet income guidelines; call 1-800-556-8317
$0/month, savings up to $175 per 30-day supply for commercially insured patients on brand Farxiga
farxiga.com/savings-support
AstraZeneca Patient Support Line (Farxiga)
Income-based assistance guidance for uninsured patients still prescribed brand Farxiga rather than the generic
azpatientsupport.com
Medicare Part D Extra Help (Low-Income Subsidy)
Reduces 2026 copays to $1.60 to $5.10 for generic dapagliflozin and $4.90 to $12.65 for brand Jardiance or Farxiga, and eliminates the Part D deductible
ssa.gov/extrahelp
A manufacturer coupon or copay card is blocked for anyone whose prescriptions are billed to Medicare, Medicaid, TRICARE, or VA under the federal anti-kickback statute (42 U.S.C. Section 1320a-7b). Medicare beneficiaries who cannot afford their Jardiance or Farxiga copay should apply for Extra Help through Social Security at 1-800-772-1213, or apply directly to the manufacturer's income-based patient assistance program, which unlike the commercial savings card is allowed for Medicare and Medicaid patients who meet income criteria.
Source: NeedyMeds.org, Boehringer Ingelheim Cares Foundation, AstraZeneca AZ&Me Patient Support, Social Security Administration Extra Help program
Medicare Part D
Medicare Part D treats the three SGLT2 options very differently in 2026. Jardiance and brand Farxiga carry federally mandated Maximum Fair Prices of $197 and $178.50 per 30-day supply that every Part D plan, including Medicare Advantage prescription drug (MA-PD) plans, must honor by law. Generic dapagliflozin, because it is a separate NDC from brand Farxiga, is not covered by that negotiated price; instead, plans assign it to their own generic formulary tier, typically producing a standard copay of $0 to $20 per month, often lower than either negotiated brand price. All three options count toward the 2026 annual Part D out-of-pocket cap of $2,100, after which covered drugs cost $0 for the rest of the calendar year.
Enrollees with Extra Help (Low-Income Subsidy) pay $1.60 for generic dapagliflozin and $4.90 for brand Jardiance or Farxiga per fill in 2026 if their income is at or below 100 percent of the federal poverty level, or $5.10 generic and $12.65 brand between 100 and 150 percent of FPL. If your plan charges more than $197 for Jardiance or $178.50 for brand Farxiga, contact your plan's member services and request they apply the Maximum Fair Price, since plans are legally required to honor it. If your plan places generic dapagliflozin on a higher tier than expected, ask your prescriber whether appealing the tier placement or switching from brand Farxiga to the generic would lower your monthly cost.
Common SGLT2 Cost on Medicare 2026 Billing Errors
All three SGLT2 options are oral tablets with no J-code, so Medicare billing problems typically involve formulary tier errors, Maximum Fair Price application failures, and brand-versus-generic substitution rather than HCPCS coding errors. Check for these before paying:
Part D plan charged more than $197 for Jardiance or $178.50 for brand Farxiga per 30-day fill in 2026: the Maximum Fair Price is federally mandated; request the plan apply it and file a coverage determination dispute if declined
Generic dapagliflozin billed at the brand Farxiga Maximum Fair Price copay instead of the lower generic formulary tier copay
Pharmacy dispensed brand Farxiga instead of the prescribed generic dapagliflozin, or vice versa, without prescriber authorization
Wrong formulary tier applied to Jardiance or brand Farxiga, placing either on a specialty tier instead of the standard tier that reflects the negotiated Maximum Fair Price
Extra Help copay not applied correctly: enrollees at or below 100 percent FPL should never pay more than $1.60 generic or $4.90 brand per fill in 2026
Charged the deductible rate after already reaching the $2,100 Part D out-of-pocket cap for the year
Frequently Asked Questions
Is there a generic for Jardiance or Farxiga in 2026?
Farxiga has a generic; Jardiance does not. The FDA approved the first generic dapagliflozin tablets on April 7, 2026, and cash prices have fallen to roughly $180 to $220 per month by September 2026. No generic empagliflozin (Jardiance) exists as of 2026; its patent is expected to hold exclusivity until approximately 2028 to 2030, so the $197 Medicare Maximum Fair Price is currently the best available Jardiance price.
How do I apply for the BI Cares patient assistance program for Jardiance?
Call 1-800-556-8317 or visit boehringer-ingelheim.com to request an application. You will need proof of household income, proof of US residency, your Medicare card if applicable, a valid Jardiance prescription, and a signed prescriber section. Processing typically takes 7 to 15 business days, and approved patients receive free Jardiance shipped directly to them, with annual reapplication required.
Can I use a Jardiance or Farxiga manufacturer savings card if I have Medicare?
No. Federal anti-kickback statute (42 U.S.C. Section 1320a-7b) prohibits manufacturer coupon cards from being used by anyone whose prescriptions are billed to Medicare, Medicaid, TRICARE, or VA. Medicare Part D enrollees instead benefit from the IRA-negotiated Maximum Fair Price ($197 for Jardiance, $178.50 for brand Farxiga) or, for generic dapagliflozin, the plan's generic formulary tier copay. Enrollees who still cannot afford their copay should apply for Extra Help through Social Security or the manufacturer's income-based patient assistance program.
What if my Medicare Part D plan denies coverage for Jardiance or Farxiga?
File a formal appeal within 60 days of the written denial notice, including a prescriber letter documenting medical necessity for the specific drug and indication. Request a peer-to-peer review between your prescriber and the plan's medical director, especially if the plan is steering you toward generic dapagliflozin without confirming clinical appropriateness. If the internal appeal fails, escalate to an Independent Review Entity at 1-800-633-4227. While the appeal is pending, apply to BI Cares or AstraZeneca Patient Support for a temporary free supply.
Does the IRA Medicare negotiated price apply to Jardiance, Farxiga, and generic dapagliflozin in 2026?
Yes for the two brands, no for the generic. Jardiance's Maximum Fair Price is $197 per 30-day supply, down from $573, and brand Farxiga's is $178.50, down from $556, both effective January 1, 2026 under the Inflation Reduction Act. Generic dapagliflozin is a separate NDC and is not covered by that negotiated price; instead, Part D plans price it through their own generic formulary tier, which often produces a lower patient copay than either negotiated brand.
What does Jardiance, Farxiga, or generic dapagliflozin cost without insurance at the pharmacy counter in 2026?
Cash retail prices in 2026 run $255 to $831 per month for Jardiance and $210 to $778 for brand Farxiga, both with a GoodRx or SingleCare coupon lowering the price substantially, for example Jardiance at $255 through Kroger's SingleCare discount. Generic dapagliflozin cash prices have fallen to roughly $180 to $220 per month by September 2026 as more generic manufacturers entered the market, making it the cheapest cash option of the three.
Do I qualify for the BI Cares or AstraZeneca patient assistance program?
BI Cares evaluates Jardiance applicants against roughly 400 percent of the federal poverty level: about $63,840 for a household of 1, $86,560 for 2, $109,280 for 3, and $132,000 for 4 in 2026, plus $22,720 for each additional household member. AstraZeneca's Farxiga program evaluates eligibility case by case; call 1-855-332-7944 to confirm current criteria. Both require proof of US residency, a valid prescription, and either no prescription drug coverage or Medicare/Medicaid enrollment with an unaffordable copay.
Which is cheaper on Medicare in 2026: Jardiance, Farxiga, or generic dapagliflozin?
Generic dapagliflozin is usually the cheapest Medicare Part D option in 2026, with a standard copay of $0 to $20 or $1.60 to $5.10 with Extra Help, because it sits on the plan's lowest generic tier rather than the negotiated brand price. Brand Farxiga's Maximum Fair Price of $178.50 is the next cheapest, followed by Jardiance at $197, since Jardiance has no generic competitor. Patients should confirm with their prescriber whether switching from a brand to the generic is clinically appropriate for their specific diagnosis, particularly for heart failure or kidney disease indications.
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