Farxiga Cost with Medicare: What You'll Actually Pay in 2026

• Key Takeaways

• What is Farxiga and Why Medicare Covers It
  • What Farxiga treats
  • How SGLT2 inhibitors work
  • Who needs this medication
• Does Medicare Cover Farxiga
  • Medicare Part D coverage for Farxiga
  • Checking your plan's formulary
  • What to do if your plan doesn't cover it
• Farxiga cost with Medicare in 2026
  • Average out-of-pocket costs
  • Cost without insurance
  • How the 2026 price negotiation affects you
  • Monthly premiums and deductibles
  • Copay expectations by plan tier
• Ways to lower your Farxiga costs
  • Ordering a 90-day supply
  • Using mail-order pharmacies
  • AstraZeneca patient assistance program
  • When to use a Farxiga coupon for Medicare
  • Generic dapagliflozin as an alternative
  • The $2,000 annual cap on drug costs
• Conclusion
• FAQs

Key takeaways

Farxiga costs more when you understand your coverage options and know what savings are available in 2026.

• Medicare covers Farxiga widely: about 90% of Medicare Part D plans include it on their formularies, and most don't require prior authorization.
• In 2026, the negotiated price drops to $178.50 monthly—a 68% reduction from the previous price.
• Once you reach the $2,000 yearly cap, you pay nothing for covered medications for the rest of that year.
• You can reduce costs further with 90-day supplies, mail-order pharmacies, and patient assistance programs.
• Check your specific plan's formulary, since coverage terms and copayments vary between Medicare Part D plans.

Medicare's negotiated pricing and the annual spending limit give important financial protection for people managing diabetes, heart failure, or chronic kidney disease.

Without insurance, Farxiga costs up to $600 per month, putting it out of reach for many people with Type 2 diabetes, heart failure, or chronic kidney disease. Medicare makes this medication much more affordable. Medicare Part D beneficiaries paid an average of $260 out-of-pocket for Farxiga in 2022, and costs are expected to drop further in 2026.

This guide answers your main questions about Medicare coverage for Farxiga: Does Medicare cover it? What will you actually pay in 2026? How do Part D plans handle coverage? You'll also learn about patient assistance options and how the new $2,000 annual cap protects you from high prescription costs.

Farxiga is used to manage type 2 diabetes and certain heart and kidney conditions. It helps the kidneys remove glucose from the body, which lowers blood sugar and protects the heart and kidneys. Medicare covers it because it improves health outcomes for beneficiaries.

What Farxiga treats

Farxiga (dapagliflozin) treats several conditions common in older adults. It reduces the risk of kidney disease progression, end-stage kidney disease, cardiovascular death, and hospitalization for heart failure in people with chronic kidney disease. About 37 million Americans have CKD.

For people with heart failure, Farxiga reduces the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits. It also helps people with Type 2 diabetes and known cardiovascular disease or multiple cardiovascular risk factors by reducing hospitalization risk for heart failure.

Farxiga improves blood sugar control when combined with diet and exercise in adults and children 10 years and older with Type 2 diabetes. Because it manages blood sugar and protects vital organs, Medicare Part D plans regularly cover it.

How SGLT2 inhibitors work

Farxiga is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It blocks your kidneys from reabsorbing glucose that has been filtered from your blood. Instead, your body removes excess glucose and sodium through urination.

This has several effects. For people with Type 2 diabetes, more glucose leaves through urine, which lowers blood sugar. For those with chronic kidney disease, it reduces pressure inside the kidney's filtering units, keeping them healthier over time. Farxiga also reduces activity in the sympathetic nervous system, which contributes to heart failure.

In the DAPA-CKD trial, Farxiga cut the risk of worsening kidney function, end-stage kidney disease, or cardiovascular or kidney death by 39% compared to placebo. It also reduced the risk of death from any cause by 31%.

Who needs this medication

Medicare beneficiaries with chronic kidney disease at risk of progression should take Farxiga, whether or not they have diabetes. It works for people with CKD stages 2–4 and elevated urinary albumin. Adults with heart failure where the heart is weak and cannot pump adequately also benefit.

People with Type 2 diabetes who have cardiovascular disease or multiple risk factors need it to prevent heart failure hospitalization. It is not used in Type 1 diabetes to improve blood sugar control. Farxiga is also not recommended for people with polycystic kidney disease or those on immunosuppressive therapy for kidney disease.

Does Medicare cover Farxiga

Medicare Part D coverage for Farxiga

About 90% of Medicare drug plans cover Farxiga. Most Medicare Part D plans cover it without requiring prior authorization. You can get coverage through either a standalone Medicare Part D plan or a Medicare Advantage Prescription Drug (MAPD) plan.

Federal regulations require Part D plans to cover most FDA-approved medications. But private insurers decide how to design their coverage. Farxiga is usually covered, though the amount of coverage and your out-of-pocket costs vary between plans.

Part D plans must cover at least two drugs in commonly prescribed categories. Even if brand-name Farxiga is not on your formulary, generic dapagliflozin or other SGLT2 inhibitors likely are.

Checking your plan's formulary

Every Medicare Part D and MAPD plan maintains a formulary—the official list of medications the plan covers. To know if Farxiga is covered under your plan, you must check this formulary.

You can review formulary information at Medicare.gov/plan-compare or by calling your plan directly. Formularies change, and your plan will notify you of changes.

If your plan doesn't cover Farxiga, you have options. Start by discussing alternatives with your doctor. For example, Jardiance is covered by every Medicare prescription drug plan. You can also request a formulary exception—your doctor must submit a letter stating the medication is medically necessary. Your plan must respond within 72 hours for a standard request or 24 hours for an expedited request if waiting could harm your health. If your plan denies the request, you can appeal. You can also switch plans during the Annual Enrollment Period (October 15 to December 7).

Farxiga cost with Medicare in 2026

Average out-of-pocket costs

Medicare Part D beneficiaries currently pay an average of $38.82 per month for Farxiga. Your actual cost depends on your plan's formulary tier, deductible, and coinsurance structure.

Cost without insurance

Without insurance, Farxiga costs between $400 and $600 per month. The list price is $377.82 for a 30-day supply as of January 1, 2026.

How the 2026 price negotiation affects you

Starting January 1, 2026, the negotiated price for Farxiga is $178.50 for a 30-day supply—a 68% discount from the 2023 list price of $556. This lower price is used to calculate your True Out-of-Pocket spending, which determines when you reach your out-of-pocket maximum.

Monthly premiums and deductibles

For 2026, the Part D national base premium is $38.99. The maximum Part D deductible rises to $615, up from $590 in 2025. Some plans offer lower deductibles or waive them entirely.

Copay expectations by plan tier

Your copay depends on which tier your plan assigns to Farxiga. Plans typically require 25% coinsurance during the initial coverage phase. With the negotiated price of $178.50, that's about $44.63 per month.

Ways to lower your Farxiga costs

Several options can reduce your Farxiga expenses beyond Medicare's negotiated prices.

Ordering a 90-day supply

A 90-day supply means fewer pharmacy trips and lower overall costs. Your insurance company must approve it, but it simplifies medication management and saves money.

Using mail-order pharmacies

Mail-order pharmacies charge less than retail locations. AstraZeneca offers a mail-order program that may save you money on Farxiga.

AstraZeneca patient assistance program

The AZ&Me program provides medications at no cost to people who cannot afford them. You may qualify if you're covered under Medicare but still struggle with costs. Once enrolled, you receive up to a 90-day supply shipped to your home at no cost. The enrollment lasts one year, and you can reapply after that.

If you have Medicare and are considering a Farxiga coupon, understand how it works with federal healthcare programs. Manufacturer coupons help commercially insured patients pay less. Federal rules prevent using these coupons directly for prescriptions covered by Medicare, Medicaid, or other federal programs. This prevents manufacturers from using coupons to influence prescribing decisions or raise prices in government programs. However, in rare cases—like if you're in the Part D coverage gap or have non-federal supplementary insurance—a coupon might help. Talk with your pharmacist or Medicare plan administrator to see if you qualify and what options you have.

You cannot use the Farxiga savings card if you have Medicare. People enrolled in state or federally funded prescription insurance programs are not eligible. However, using a discount program instead of your Medicare coverage might save you money in some situations.

Generic dapagliflozin as an alternative

Generic dapagliflozin costs around $400—still expensive, but less than the brand name.

The $2,000 annual cap on drug costs

The maximum out-of-pocket cost for 2026 Part D drugs is $2,100. Once you reach this limit, your plan covers 100% of covered medication costs for the rest of the year.

Conclusion

Medicare makes Farxiga much more affordable than the $600 monthly price without insurance. The 2026 negotiated price of $178.50 per month offers real savings, especially with the new $2,000 annual out-of-pocket cap. Check your plan's formulary to confirm coverage. If you still struggle with costs, patient assistance programs and mail-order options can help further.

FAQs

Q: Does Medicare Part D cover Farxiga? Yes. About 90% of Medicare Part D plans cover Farxiga. You can get it through a standalone Part D plan or a Medicare Advantage Prescription Drug (MAPD) plan. Most plans cover it without requiring prior authorization, though coverage details and costs vary.

Q: What will I pay for Farxiga with Medicare in 2026? Medicare beneficiaries currently pay an average of $38.82 per month. Starting January 1, 2026, the negotiated price is $178.50 for a 30-day supply. Your actual cost depends on your plan's tier, deductible, and coinsurance structure, typically around 25% during the initial coverage phase.

Q: Can I use a Farxiga coupon or savings card with Medicare? No. You cannot use the Farxiga savings card if you're enrolled in Medicare or other state or federally funded prescription insurance programs. In some cases, using a discount program instead of your Medicare coverage might cost less.

Q: What conditions does Farxiga treat? Farxiga treats Type 2 diabetes, chronic kidney disease (stages 2–4), and heart failure. It reduces the risk of kidney disease progression, cardiovascular death, and hospitalization for heart failure. It also improves blood sugar control in adults and children 10 years and older with Type 2 diabetes.

Q: What should I do if my Medicare plan doesn't cover Farxiga? Request a formulary exception with written support from your doctor stating it's medically necessary. Your plan must respond within 72 hours for standard requests or 24 hours for expedited reviews. You can also discuss alternative SGLT2 inhibitors with your doctor or switch plans during the Annual Enrollment Period (October 15 to December 7).