Jardiance (empagliflozin) is an SGLT2 inhibitor approved for type 2 diabetes, heart failure, and chronic kidney disease. Insurance coverage is generally strong for all approved indications, though tier placement and prior authorization requirements vary. Jardiance was also selected for Medicare price negotiation under the Inflation Reduction Act.
Key Facts
Check Your Specific Plan's Formulary
Coverage varies by plan. Use our formulary checker tool to look up your exact copay and restrictions.
Open Formulary CheckerSources and standards behind this page
Drug coverage in the United States is governed by published rules rather than by any one insurer's summary, and the sources below are the primary ones. They are linked so a reader can check a claim without taking this page's word for it.
- FDA Orange Book publishes the therapeutic-equivalence ratings that decide whether a generic may be substituted for a brand-name drug.
- FDA generic drug facts sets out what "generic equivalent" means and what a manufacturer must prove.
- CMS prescription drug coverage defines the rules a Medicare drug plan formulary must follow and how it may change mid-year.
- Medicare.gov drug coverage (Part D) states what a Part D plan is required to offer a member.
- CMS prescription drug appeals documents the coverage-determination and exception process when a drug is denied.
This page describes how coverage and formularies work. It is not medical advice, and a reader's own plan documents and prescriber decide what applies to them.
Frequently Asked Questions
Most insurance plans cover Jardiance for heart failure (HFrEF and HFpEF) following its FDA approval for this indication. Prior authorization is commonly required, and your doctor will need to document the diagnosis. Some plans may require trying other heart failure medications first through step therapy protocols.
As of 2026, there is no generic empagliflozin available. Patent protection continues for several more years. The IRA Medicare price negotiation may help reduce costs for Medicare beneficiaries. In the meantime, manufacturer savings programs and patient assistance are available.
Some plans prefer Farxiga (dapagliflozin) or another SGLT2 inhibitor over Jardiance. If your plan requires trying the preferred alternative first, your doctor can prescribe it or request a formulary exception for Jardiance with clinical justification. All SGLT2 inhibitors have similar mechanisms but may differ in specific FDA-approved indications.
Related Resources
- Medicare Part D Formulary 2026
- UnitedHealthcare Formulary 2026
- Cigna Formulary 2026
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