Jardiance (empagliflozin) has no FDA-approved generic equivalent as of 2026, and a 30-day supply commonly costs $560–$790 at retail cash price. For people without drug coverage — or with a plan that puts Jardiance on an expensive non-preferred tier — that price can mean skipping doses or going without.
Jardiance Cost Without Insurance 2026
Without insurance or patient assistance, Jardiance is expensive. Here are the exact numbers:
| Price Type | 30-Day Supply (10 mg or 25 mg) |
|---|---|
| Manufacturer list price (WAC) | ~$630–$650 |
| Typical retail cash price | ~$560–$790 |
| GoodRx coupon price | ~$249–$560 |
| SingleCare coupon price | ~$530 |
| Costco/Sam's Club cash | ~$500–$600 |
| 90-day supply (cash) | ~$1,500–$2,100 |
Annual cost without assistance: $6,700–$9,500+ per year. The BI Cares PAP reduces this to $0 for eligible patients. The Jardiance Savings Card reduces it to $10/month ($120/year) for commercially insured patients.
Jardiance Copay Assistance & Phone Numbers
Patients searching for Jardiance copay assistance or the manufacturer phone number need direct, scannable contact info. Boehringer Ingelheim operates two separate lines — one for the free-drug PAP, one for the savings card.
| Program | Phone Number | Purpose | Hours (ET) |
|---|---|---|---|
| BI Cares PAP | 1-800-556-8317 | Free medication for eligible uninsured/underinsured patients | Mon–Fri, 8am–8pm |
| Jardiance Savings Card | 1-866-279-8990 | Copay assistance for commercially insured patients ($10/month) | Mon–Fri, 8am–8pm |
| General Jardiance Support | 1-800-542-6257 | Product information, side effects, dosing questions | Mon–Fri, 8am–8pm |
Which number to call: If you are uninsured or on Medicare without Extra Help, call 1-800-556-8317 (BI Cares). If you have commercial insurance and want a lower copay, call 1-866-279-8990 (Savings Card). Calling the wrong line will result in a redirect and delay.
The Boehringer Ingelheim Cares Foundation exists specifically for this gap. It's a separate charitable arm from Boehringer Ingelheim's insurance-facing savings card, and it works more like a need-based grant than a coupon: instead of shaving dollars off a copay, it can supply the medication completely free to patients who qualify.
This guide walks through who typically qualifies, what income limits look like heading into the back half of 2026, how Medicare patients are treated differently, and what a complete application actually requires.
Table of Contents
- What Is the Jardiance Patient Assistance Program?
- Copay Assistance & Phone Numbers
- Jardiance PAP vs the Jardiance Savings Card
- Synjardy Patient Assistance
- Eligibility Requirements
- Income Limits by Household Size
- Medicare and Medicaid Patients
- Does Medicare Cover Jardiance?
- Required Documents
- Decision Tree: Which Program Fits You?
- How to Apply — Step by Step
- Application Form 2026
- How to Get Jardiance for Free
- Common Reasons Applications Are Denied
- What to Do If You're Denied
- Frequently Asked Questions
What Is the Jardiance Patient Assistance Program?
The Jardiance PAP is one of several medication programs run through the Boehringer Ingelheim Cares Foundation, a non-profit that also covers other Boehringer Ingelheim brands such as Ofev, Aptivus, Gilotrif, Spevigo and Cyltezo. Each medication is reviewed under the same general foundation framework, though specific income thresholds can vary by drug.
Unlike prior authorization, which is an insurance company deciding whether to pay for a prescription you already have coverage for, the PAP exists for people who don't have adequate coverage in the first place. If approved, the foundation ships the medication directly rather than reimbursing a pharmacy claim.
| Feature | Detail |
|---|---|
| Administered by | Boehringer Ingelheim Cares Foundation |
| Cost to eligible patients | $0 for approved medication |
| Application submitted by | Patient + prescribing healthcare provider |
| Typical approval period | Set period with required annual renewal |
| Delivery method | Shipped directly to patient or provider, not filled at a retail pharmacy |
Jardiance PAP vs the Jardiance Savings Card
These two programs get confused constantly because they're both run by the same manufacturer and both reduce what you pay for Jardiance. They are not interchangeable.
| Feature | Patient Assistance Program (BI Cares) | Jardiance Savings Card |
|---|---|---|
| Who it's for | Uninsured or underinsured, income-qualifying patients | Commercially insured patients |
| Cost to patient | $0 | As low as $10 for a 1–3 month supply, per published card terms |
| Medicare eligible? | Yes, under specific conditions | No |
| Income requirement | Yes — must be at or below FPL threshold | No income requirement |
| Requires prescriber sign-off | Yes | No |
| Renewal | Annual reapplication | Automatic re-enrollment if still eligible |
Applying to the wrong one wastes time. If you have commercial insurance and just want a lower copay, the savings card is faster and has no income review. If you're uninsured or your plan won't cover Jardiance at all, the savings card won't help — you need the PAP.
Synjardy Patient Assistance Program (Empagliflozin / Metformin)
Synjardy and Synjardy XR — the combination of empagliflozin and metformin — are also covered under the Boehringer Ingelheim Cares Foundation at the same 400% FPL income limit as Jardiance. If you take Synjardy instead of Jardiance, you do not need a separate foundation — the same BI Cares application covers both medications.
| Feature | Jardiance | Synjardy / Synjardy XR |
|---|---|---|
| Active ingredient(s) | Empagliflozin only | Empagliflozin + metformin |
| BI Cares income limit | 400% FPL | 400% FPL (same) |
| Application process | BI Cares online/mail/fax | BI Cares online/mail/fax (same) |
| Phone number | 1-800-556-8317 | 1-800-556-8317 (same) |
| Medicare eligibility | Yes, if no Extra Help | Yes, if no Extra Help |
Synjardy tip: Because Synjardy combines two diabetes medications into one pill, your prescriber must document why combination therapy is appropriate versus separate Jardiance + metformin prescriptions. The foundation may request this clinical justification during review.
Eligibility Requirements
Program pages and third-party guides describe eligibility slightly differently, but the following criteria show up consistently across current 2026 sources.
- U.S. resident or resident of a U.S. territory
- Uninsured, or insured with coverage that doesn't adequately pay for Jardiance
- Household income at or below the program's income threshold
- Valid, active prescription from a licensed U.S. prescriber
- Not already receiving full Medicaid drug coverage for Jardiance
Income verification: Some applications allow income to be verified electronically using the last four digits of a Social Security number, which can be faster than mailing paycheck stubs or a tax return. If electronic verification isn't available, a copy of a 1040 tax return is typically accepted instead.
Income Limits by Household Size (2026)
The Boehringer Ingelheim Cares Foundation sets income limits at 400% of the federal poverty level for Jardiance. These are the exact 2026 thresholds:
| Household Size | Maximum Annual Income (400% FPL) | Approximate Monthly Limit |
|---|---|---|
| 1 Person | $63,800 | ~$5,316 |
| 2 People | $86,200 | ~$7,183 |
| 3 People | $108,600 | ~$9,050 |
| 4 People | $131,000 | ~$10,916 |
| 5 People | $153,400 | ~$12,783 |
| 6 People | $175,800 | ~$14,650 |
Alaska and Hawaii have higher limits. For example, Alaska's 400% FPL for one person is approximately $79,750. These figures are based on the 2026 HHS Federal Poverty Guidelines published at HHS.gov.
How income is verified: BI Cares can verify income electronically using the last four digits of your Social Security number. If electronic verification fails, submit a copy of your most recent federal tax return (1040) or two recent pay stubs.
Medicare and Medicaid Patients
Jardiance's PAP treats government coverage differently than most commercial-only assistance programs, which is worth understanding before you assume you're excluded.
| Coverage Situation | PAP Eligibility |
|---|---|
| Medicare Part D, no Extra Help | May qualify if income limit is met |
| Medicare Part D with Extra Help (LIS) | Generally not eligible |
| Full Medicaid drug coverage | Generally not eligible |
| Commercial insurance excluding Jardiance | Case-by-case — documentation of the exclusion required |
| Completely uninsured | Eligible if income limit is met |
This is one of the more patient-friendly design choices in the Jardiance PAP: many manufacturer programs cut off Medicare patients entirely, but this one specifically builds a path for Part D beneficiaries who fall through the cracks of Extra Help eligibility.
Does Medicare Cover Jardiance?
Yes. Medicare Part D covers Jardiance (empagliflozin) in 2026. It is typically classified as a Tier 3 (non-preferred brand) drug, which means higher copays than generics or preferred brands.
| Coverage Detail | Cost |
|---|---|
| Typical Part D copay (Tier 3) | ~$42–$95/month |
| Part D deductible (must be met first) | ~$615 in 2026 |
| Annual out-of-pocket cap | $2,100 (then $0 for rest of year) |
| With Extra Help (LIS) | $0–$15/month |
| Jardiance Savings Card eligible? | No — federally prohibited |
Medicare patients: If your Part D copay is unaffordable, apply for Extra Help (Low-Income Subsidy) through Social Security. It can reduce your Jardiance copay to near $0. If you don't qualify for Extra Help and meet income limits, the BI Cares PAP may provide Jardiance at no cost.
Required Documents
| Document | Usually Required |
|---|---|
| Completed application, patient section | Yes |
| Completed application, prescriber section | Yes |
| Proof of income (or electronic verification) | Yes |
| Proof of insurance status or denial letter | Yes |
| Active prescription details | Yes |
| Proof of Extra Help denial (Medicare applicants) | If applicable |
Decision Tree: Which Program Fits You?
Do you have commercial insurance?
Start here — this decides which program applies
Copay too high?
No income review needed
Use the Savings Card
Apply through the Jardiance website
Income at or below limit?
Check current FPL threshold for your household size
Apply to the BI Cares PAP
Prescriber must complete their section
Denied or over the limit?
Look at independent copay foundations next
How to Apply — Step by Step
Confirm you have the right program
Check whether you're uninsured, underinsured or on Medicare without Extra Help — the PAP is built for these situations, not for commercially insured patients looking for a lower copay.
Gather income documentation
Have a recent tax return or pay stubs ready in case electronic income verification using your Social Security number isn't available or doesn't clear automatically.
Get your prescriber's section completed
The application requires your prescribing healthcare provider to confirm the prescription and sign their portion. Ask your provider's office if they have a staff member who regularly handles PAP paperwork.
Submit by mail, fax or online
The Boehringer Ingelheim Cares Foundation accepts applications online, by mail and by fax. Keep a copy of everything you submit, including the date.
Track your status and plan for renewal
If approved, mark your renewal date. Reapplication typically requires refreshed income and insurance documentation, so don't wait until the last week of your approval window to start gathering paperwork again.
Jardiance PAP Application Form 2026
The Boehringer Ingelheim Cares Foundation accepts applications through three channels. As of August 2026, there is no standalone "PDF download" portal — the form is accessed through the official BI Cares website or requested by phone.
How to get the 2026 application:
- Online (fastest): Boehringer Ingelheim Cares Portal — complete digitally and submit with uploaded documents
- Phone request: Call 1-800-556-8317 (Mon–Fri, 8am–8pm ET) to request a paper form by mail
- Prescriber's office: Many endocrinology and primary care clinics keep blank BI Cares forms on hand
Processing time: 2–4 weeks for new applications. 1–2 weeks for renewals.
What the Application Includes
- Patient section: Name, address, household size, income, insurance status, signature, and date
- Prescriber section: Doctor confirms your diabetes, heart failure, or CKD diagnosis; specifies Jardiance or Synjardy dose; signs and dates
- Income verification: Electronic verification (last 4 SSN digits) OR copy of your most recent 1040 tax return OR two recent pay stubs
- Insurance documentation: Copy of insurance card (front and back) OR Medicare Extra Help denial letter OR proof of uninsured status
Top rejection reasons: Missing prescriber signature, income documentation over 90 days old, or applying for the savings card instead of the PAP. Double-check that you're on the Boehringer Ingelheim Cares Foundation page — not the Jardiance Savings Card portal.
How to Get Jardiance for Free in 2026
There are three realistic paths to $0 Jardiance as of August 2026. No generic exists yet, so these are your only manufacturer-backed options.
| Path | Who Qualifies | Your Cost | How to Start |
|---|---|---|---|
| BI Cares PAP | Uninsured/underinsured, ≤400% FPL | $0 | Call 1-800-556-8317 or apply online |
| Medicare + Extra Help (LIS) | Medicare beneficiaries with low income/assets | $0–$15/month | Apply at ssa.gov/extrahelp |
| Medicaid | State Medicaid enrollees | $0–$3/month | Confirm Jardiance is on your state formulary |
There is no "free 30-day trial" coupon for Jardiance. AstraZeneca offers trial vouchers for some drugs, but Boehringer Ingelheim does not currently distribute a standalone free Jardiance trial. The Jardiance Savings Card is the active manufacturer discount — it lowers copays but does not make the medication free.
Common Reasons Applications Are Denied
| Reason | What It Usually Means |
|---|---|
| Income above threshold | Household income exceeds the current FPL limit for your household size |
| Existing adequate coverage | Insurance, Medicaid, or Medicare Extra Help already covers Jardiance |
| Missing prescriber signature | Application is treated as incomplete until the provider section is finished |
| Income verification failed | Electronic check didn't clear; a 1040 or pay stubs may be required instead |
| Expired documentation | Income or insurance proof too old to be accepted at renewal |
What to Do If You're Denied
1. Ask for the specific denial reason. Many denials are administrative — a missing signature or an income-verification hiccup — rather than a final no.
2. Resubmit with corrected documentation. If the issue was a missing document or an income mismatch, a corrected resubmission is often faster than starting over.
3. Look at independent copay foundations. Organizations such as NeedyMeds, RxAssist and the HealthWell Foundation sometimes fund diabetes medications when manufacturer programs don't apply to your situation.
4. Check the HealthWell Foundation. For patients with heart failure or chronic kidney disease, the HealthWell Foundation may provide copay or premium assistance grants specifically for cardiovascular or renal diagnoses.
5. Consider Steglatro (ertugliflozin). If Jardiance is unaffordable and no assistance program applies, ask your prescriber about Steglatro — another SGLT2 inhibitor in the same drug class that is sometimes priced lower than Jardiance at cash pay.
6. Ask your pharmacy about discount cards. Independent prescription discount programs can lower the cash price of Jardiance even without a formal assistance program, though savings are typically smaller than a PAP approval.
7. Talk to your prescriber about alternatives. If Jardiance genuinely isn't affordable and no assistance program applies, your provider may have other treatment options with lower out-of-pocket costs on your specific formulary.
Frequently Asked Questions
Generally, U.S. residents who are uninsured or whose insurance doesn't adequately cover Jardiance, and whose household income falls at or below the program's income threshold.
Medicare Part D beneficiaries who don't qualify for Extra Help (the Low-Income Subsidy) may still qualify for the PAP if their income meets the program's limit.
No. The savings card lowers copays for commercially insured patients only. The Patient Assistance Program provides free medication to qualifying uninsured or underinsured patients, and Medicare beneficiaries cannot use the savings card.
The Boehringer Ingelheim Cares Foundation uses 400% of the federal poverty level for Jardiance and Synjardy as of August 2026. For one person, that is approximately $63,800/year. For a family of four, $131,000/year. Alaska and Hawaii have higher limits. Confirm your household size against the income limits table above before applying.
Approval periods vary, and patients generally need to reapply annually with updated income and insurance documentation.
Yes. The application requires a section completed and signed by your prescribing healthcare provider confirming the prescription and medical need.
Generally, no, if Medicaid already provides full drug coverage for Jardiance in your state. Medicaid formulary gaps may be reviewed case by case with supporting documentation.
You can ask for the specific denial reason, resubmit with corrected documentation, or explore independent copay foundations and prescription discount programs while you wait.
Yes. The Boehringer Ingelheim Cares Foundation also covers other brands including Ofev, Aptivus, Gilotrif, Spevigo and Cyltezo, though income thresholds may differ by medication.
No. As of July 2026, the FDA has not approved a generic version of empagliflozin. While generic manufacturers have filed Abbreviated New Drug Applications (ANDAs), Boehringer Ingelheim's patents and exclusivity protections extend into 2028 and beyond. The earliest expected generic entry is 2028–2029. Some fraudulent online pharmacies claim to sell "generic Jardiance" — these products are unapproved and potentially unsafe.
Jardiance is co-developed and co-marketed by Boehringer Ingelheim and Eli Lilly. However, the patient assistance program is administered exclusively by the Boehringer Ingelheim Cares Foundation — not Lilly Cares. If you call Lilly Cares about Jardiance, they will redirect you to BI Cares at 1-800-556-8317.
Yes. The same Boehringer Ingelheim Cares Foundation application covers Synjardy and Synjardy XR (empagliflozin/metformin) at the same 400% FPL income limit. Your prescriber must specify Synjardy on the application and document why combination therapy is appropriate.
There is no standalone public PDF download link. The application is accessed through the BI Cares online portal or requested by calling 1-800-556-8317. Some prescriber offices keep printable forms on hand.
No. Boehringer Ingelheim does not offer a free 30-day trial voucher for Jardiance as of August 2026. The Jardiance Savings Card is the active manufacturer discount program. For the lowest first-month cost, uninsured patients should explore the BI Cares PAP (potentially $0) or pharmacy discount cards (~$249–$560).
Yes. Medicare Part D covers Jardiance for Type 2 diabetes, heart failure, and chronic kidney disease. It is typically a Tier 3 drug with copays around $42–$95/month. Once your annual out-of-pocket spending hits $2,100, Jardiance costs $0 for the rest of the year. Medicare patients cannot use the manufacturer savings card but may qualify for the BI Cares PAP if they don't receive Extra Help.
Jardiance copay assistance is the Jardiance Savings Card, a manufacturer copay card for commercially insured patients. It lowers your pharmacy cost to as low as $10 per 1–3 month supply. It is not a free-drug program — it is a discount applied at the pharmacy counter. Medicare, Medicaid, and TRICARE patients are ineligible.
How We Researched This Guide
References
- Boehringer Ingelheim — Patient Assistance Program information
- NeedyMeds — current Federal Poverty Level guidelines
- RxAssist — independent patient assistance program directory
- HealthWell Foundation — independent copay assistance
- Medicare.gov — Extra Help / Low-Income Subsidy information
Related Resources
- NovoCare vs Lilly Cares: Patient Assistance Compared
- Ozempic Prior Authorization Requirements
- How to Appeal a Prescription Denial
- Jardiance Drug Guide
- Farxiga Patient Assistance Program 2026
Editorial Policy: Refill Relay medical content is researched using manufacturer patient assistance program pages, Federal Poverty Level guidance, and current third-party reporting on 2026 program changes. Because manufacturer PAP rules and income thresholds can change without notice, always confirm current figures directly with the Boehringer Ingelheim Cares Foundation before submitting an application.