Yes, Humana does cover Jardiance (empagliflozin) on its 2026 formularies. The drug sits at Tier 3 on Humana’s Medicare Part D, Medicare Advantage, and commonly prescribed drug lists, and it is also covered under Humana’s Managed Medicaid plans with additional requirements.1Humana. 2026 Commonly Prescribed Drug List – Humana Premier PDP What you actually pay, and whether you need advance approval, depends on which Humana plan you carry.
Where Jardiance Sits on the Humana Formulary
Jardiance is a Tier 3 drug on Humana’s 2026 formulary, grouped with two other SGLT2 inhibitors: brand-name Farxiga and the generic dapagliflozin propanediol. All three share the same tier, so switching to the generic alternative within Humana’s lineup does not lower your cost.1Humana. 2026 Commonly Prescribed Drug List – Humana Premier PDP
Other SGLT2 inhibitors, including Invokana and Steglatro, are not on the Humana formulary. Patients prescribed those drugs would need to switch to a covered option like Jardiance or request a formulary exception.1Humana. 2026 Commonly Prescribed Drug List – Humana Premier PDP
Do You Need Prior Authorization?
The answer depends on your plan type.
If you have a Humana Medicare plan, whether a standalone Prescription Drug Plan or a Medicare Advantage plan with Part D, there is no prior authorization, step therapy, or quantity limit for Jardiance. Your doctor writes the prescription and you fill it at the pharmacy.2PrescriberPoint. Jardiance Coverage – Humana
If you have a Humana Managed Medicaid (HMO) plan, Humana requires both prior authorization and step therapy. That means you may need to try and fail on a less expensive medication before Jardiance is approved.2PrescriberPoint. Jardiance Coverage – Humana The specific step therapy criteria are published through Humana’s Medicaid pharmacy page.3Humana. Humana Medicaid Pharmacy Coverage
What You’ll Pay in 2026
Jardiance is one of the first ten drugs subject to Medicare price negotiation under the Inflation Reduction Act. The negotiated price took effect January 1, 2026, dropping a 30-day supply to $197 from a previous list price of $573.4CMS. Selected Drugs and Negotiated Prices5Center for Medicare Advocacy. Medicare Announces Results of First Round of Historic Drug Price Negotiations All Medicare Part D plans, including Humana’s, must honor that price. Average out-of-pocket costs for the negotiated drugs are expected to fall roughly 50% compared to 2025.6AARP. Future Medicare Drug Payment Changes
Your exact copay depends on your Humana plan’s Tier 3 cost-sharing structure, so check your plan documents or call customer service for a precise figure. As a benchmark, most patients with Medicare Part D pay between $0 and $50 per month for Jardiance, and Medicaid enrollees typically pay between $0 and $8 per month.7GoodRx. Jardiance Generic The manufacturer’s retail price as of January 2026 is $350 for a 30-day supply.8Boehringer Ingelheim. Jardiance Cost
On top of the negotiated price, the Inflation Reduction Act caps total out-of-pocket Part D spending at $2,100 in 2026. Once you hit that ceiling, you pay nothing more for covered drugs for the rest of the year.6AARP. Future Medicare Drug Payment Changes
No generic version of Jardiance is available, and none is expected before 2029 due to patent protections.7GoodRx. Jardiance Generic
Manufacturer Savings and Assistance
Boehringer Ingelheim offers a Jardiance Savings Card that can bring the copay as low as $0 for a 30- to 90-day prescription. One important limit: the card is not available to Medicare, Medicaid, or cash-paying patients. If you have Humana commercial insurance, the manufacturer reports eligible patients pay an average of about $15 per month on a 90-day prescription.9Boehringer Ingelheim. Jardiance Savings and Access
Patients who cannot afford the drug at all may qualify for the Boehringer Ingelheim Cares Foundation patient assistance program, which provides Jardiance free of charge to eligible individuals.7GoodRx. Jardiance Generic
If Humana Denies Your Jardiance Coverage
If Humana denies coverage or places Jardiance at a tier that makes it unaffordable, you have two main options: request a formulary exception or file a formal appeal.
Requesting a Formulary Exception
A formulary exception asks Humana to cover a drug that is not on the formulary, or to cover it at a lower cost-sharing tier. Your doctor can start the process by contacting Humana Clinical Pharmacy Review at 1-800-555-2546 during business hours, or through the provider portal at Humana.com/Providers.10Humana. Drug Exceptions and Appeals You can also submit your own request online through Humana’s Part D prior authorization portal, by fax to 877-486-2621 using a coverage determination form, or by phone at 800-555-CLIN (2546).11Humana. Prior Authorization and Medication Approvals
Filing an Appeal
If the exception request is denied, you can appeal in writing to Humana Grievances and Appeals, P.O. Box 14546, Lexington, KY 40512-4546, or by calling the Customer Care number on your Humana ID card.10Humana. Drug Exceptions and Appeals Medicare members who are denied at the plan level have 65 days to request a redetermination, the first step in a five-level federal appeals process. Expedited decisions are available at the first two levels if a standard timeline could endanger your health, with a 72-hour turnaround.12Medicare.gov. Drug Plan Appeals