Jardiance Cost in Wisconsin 2026: Prices, Medicaid, Insurance, and Legal Compounding Options

What Is the Cash Price of Jardiance in Wisconsin in 2026?

Brand-name Jardiance carries a manufacturer list price of approximately $680 per month at Wisconsin retail pharmacies in 2026, whether you fill at a Walgreens in Milwaukee or an independent pharmacy in Green Bay. Without insurance or a savings program, that is the number you will see at the counter. GoodRx and similar discount platforms negotiate modest reductions, but cash prices rarely fall below $590 to $630 for the brand product at in-network Wisconsin retailers.

The active ingredient in Jardiance is empagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor. The FDA first approved empagliflozin 10 mg and 25 mg tablets in August 2014 for type 2 diabetes management [1]. The drug reduces blood glucose by blocking renal glucose reabsorption, which also produces clinically meaningful reductions in blood pressure, body weight, and intraglomerular pressure, benefits that extend well beyond glycemic control [2].

Price variation across Wisconsin zip codes is modest. Urban pharmacies in Madison and Milwaukee tend to match the national list price closely, while some independent rural pharmacies may charge slightly more due to wholesaler logistics. Calling ahead to confirm the dispensed price before driving is a practical step for any Wisconsin patient.

A straightforward way to think about Wisconsin pricing tiers in 2026:

1. No coverage, no card: ~$680/month (brand list price)
2. GoodRx or similar discount card: ~$590 to $630/month
3. Commercial insurance with formulary placement: $25 to $100/month typical copay
4. Boehringer Ingelheim/Lilly savings card: as low as $10/month
5. Wisconsin Medicaid (with PA approved): $0 to $4/month (Medicaid copay schedule)
6. Compounded empagliflozin from a licensed 503A pharmacy: $0 to $80/month depending on program

Does Wisconsin Medicaid Cover Jardiance?

Wisconsin Medicaid covers Jardiance with a prior authorization (PA) requirement for three indications: type 2 diabetes mellitus, heart failure with reduced or preserved ejection fraction, and chronic kidney disease. PA approval is not guaranteed on the first submission, but well-documented clinical notes that include HbA1c values, eGFR measurements, and a record of metformin or other first-line agents strengthen the case substantially.

The Wisconsin Medicaid preferred drug list (PDL) places empagliflozin in a non-preferred tier for most enrollees, which triggers the PA step. Prescribers submit the PA through the ForwardHealth portal. Turnaround is typically three to five business days for standard requests or 24 hours for urgent cases. Once approved, most Wisconsin Medicaid enrollees pay $0 to $4 per 30-day fill under the state's nominal copay schedule.

A 2024 analysis in the Journal of the American Medical Association found that SGLT2 inhibitor utilization among Medicaid enrollees with heart failure remained significantly below guideline-recommended levels nationally, largely due to PA barriers [3]. Wisconsin clinicians who proactively document ejection fraction, NYHA class, and eGFR in the PA submission see higher approval rates on first submission.

The American Diabetes Association's 2024 Standards of Care state that SGLT2 inhibitors "with proven cardiovascular benefit are recommended for patients with type 2 diabetes and established cardiovascular disease or high cardiovascular risk" [4]. Citing that guideline language in a PA letter can meaningfully reduce the chance of denial.

Which Insurance Plans Cover Jardiance in Wisconsin?

Most commercial insurance plans sold through the Wisconsin Health Insurance Marketplace, employer group plans, and Medicare Part D plans cover empagliflozin, though tier placement and step-therapy requirements vary by plan year.

Medicare Part D in Wisconsin: As of January 2025, the Inflation Reduction Act capped annual Medicare out-of-pocket drug costs. Patients who reach the $2,000 cap pay $0 for the remainder of the plan year. Before reaching that cap, Part D plans in Wisconsin typically place Jardiance on Tier 3 or Tier 4, meaning a monthly copay of $47 to $110 is common in the coverage phase. The Medicare Extra Help (Low Income Subsidy) program can reduce or eliminate those costs for qualifying Wisconsin seniors.

ACA Marketplace plans: Silver and Gold plans in Wisconsin commonly cover Jardiance on formulary Tier 3. A patient with a Silver plan and an $8,000 deductible may pay full list price until the deductible clears, then a lower copay. Using a manufacturer savings card while on an ACA plan is permitted in 2026, unlike the prior restriction that blocked savings card use for deductible accumulation on ACA metal plans.

Employer-sponsored plans: The majority of large-group plans in Wisconsin cover Jardiance, though some require step therapy through metformin, a different SGLT2 inhibitor, or a GLP-1 receptor agonist first. Step-therapy exceptions are available under Wisconsin state law (s. 632.861) when a prescriber documents clinical reasons why the required first-line drug is contraindicated or previously failed [5].

A cardiologist or endocrinologist letter citing EMPA-REG OUTCOME data is often sufficient to satisfy a step-therapy exception request. In EMPA-REG OUTCOME (N=7,020), empagliflozin produced a 38% relative risk reduction in cardiovascular death compared to placebo in patients with type 2 diabetes and established cardiovascular disease (hazard ratio 0.62 to 95% CI 0.49 to 0.77, P<0.001) [6]. That level of cardiovascular mortality reduction is difficult for a payer medical director to dismiss.

How Does the Boehringer Ingelheim/Lilly Savings Card Work in Wisconsin?

Commercially insured Wisconsin patients who are not on a government program (Medicaid, Medicare, CHIP, or VA) are eligible for the Boehringer Ingelheim and Lilly co-pay savings card, which reduces out-of-pocket costs to as low as $10 per 30-day supply.

The card is valid at participating Wisconsin retail pharmacies and select mail-order pharmacies. Enrollment takes under five minutes at the Jardiance website or through the prescribing provider. The card cannot be used alongside Medicaid or Medicare Part D. Annual savings are capped at $5,400, which is sufficient to cover most commercially insured patients through a full year at the $10/month rate.

Patients on high-deductible health plans should confirm with their plan administrator whether savings card amounts count toward their deductible. Under current IRS guidance, HDHP-enrolled patients using manufacturer copay assistance before meeting their deductible may affect HSA contribution eligibility. This is a nuance worth a short conversation with a benefits coordinator or tax advisor.

Is Compounded Empagliflozin Legal in Wisconsin?

Compounded empagliflozin prepared by a licensed 503A pharmacy is currently legal in Wisconsin. 503A refers to pharmacies operating under Section 503A of the Federal Food, Drug, and Cosmetic Act, which permits patient-specific compounding when a valid prescription exists [7].

The FDA's enforcement posture on compounded SGLT2 inhibitors differs from its stance on compounded semaglutide. As of mid-2025, the FDA has not placed empagliflozin on its shortage list, and no final rule prevents 503A compounding of empagliflozin for an individual patient with a specific prescription. Wisconsin's Pharmacy Examining Board requires that any 503A pharmacy serving Wisconsin patients hold an active Wisconsin pharmacy license or reciprocal registration, and that the compounded preparation meet USP standards.

Several Wisconsin-licensed telehealth practices now partner with 503A compounding pharmacies to supply empagliflozin at substantially lower costs, sometimes included in a monthly membership fee. Because compounded drugs are not FDA-approved finished products, they do not carry the same labeling, standardization, or bioequivalence data as brand Jardiance. Patients should confirm the pharmacy's USP Chapter 795 compliance, lot testing records, and Wisconsin licensing before starting a compounded product.

The FDA's Office of Pharmaceutical Quality has issued guidance noting that quality testing for beyond-use dating and potency is mandatory for all 503A compounded preparations [8]. Ask the pharmacy for a certificate of analysis for each lot.

What Are the Clinical Indications That Justify Jardiance Coverage in Wisconsin?

Understanding the approved indications strengthens both PA submissions and conversations with payers. The FDA has approved empagliflozin for three distinct indications, each supported by large outcomes trials [1].

Type 2 diabetes mellitus: Approved 2014 to 10 mg or 25 mg once daily. Reduces HbA1c by approximately 0.5% to 0.8% as add-on therapy [9].

Heart failure (HFrEF and HFpEF): Approved 2021 based on the EMPEROR-Reduced and EMPEROR-Preserved trials. In EMPEROR-Reduced (N=3,730), empagliflozin reduced the composite of cardiovascular death or hospitalization for heart failure by 25% versus placebo (hazard ratio 0.75 to 95% CI 0.65 to 0.86, P<0.001) [10].

Chronic kidney disease: Approved 2023 based on the EMPA-KIDNEY trial (N=6,609). Empagliflozin reduced the risk of kidney disease progression or cardiovascular death by 28% versus placebo (hazard ratio 0.72 to 95% CI 0.64 to 0.82, P<0.001) [11].

Each of these approved indications is a basis for a Wisconsin Medicaid PA and a commercial step-therapy exception. Documenting which indication applies and citing the corresponding trial in the prescriber notes is the single most effective way to accelerate coverage approval.

What Side Effects and Contraindications Matter for Wisconsin Prescribers?

Empagliflozin is contraindicated in patients with eGFR <20 mL/min/1.73m² for the diabetes indication (though it is used down to lower eGFR thresholds for the CKD indication under the EMPA-KIDNEY protocol) and in patients with type 1 diabetes due to the risk of diabetic ketoacidosis (DKA) [1].

Genital mycotic infections occur in roughly 6% to 8% of women and 3% to 4% of men on empagliflozin in clinical trials [9]. Urinary tract infections are modestly elevated. Fournier gangrene is a rare but serious risk (fewer than 55 cases reported globally through 2019 across all SGLT2 inhibitors) [12].

Volume depletion is a practical concern for Wisconsin patients on loop diuretics for heart failure. Dose reduction of the diuretic by 25% to 50% at empagliflozin initiation may be appropriate, particularly in older adults. The prescriber should recheck electrolytes and renal function two to four weeks after starting.

Euglycemic DKA, which presents without markedly elevated glucose, is reported rarely with empagliflozin and more commonly in patients who are fasting perioperatively or consuming very low carbohydrate diets. Standard guidance from the American Association of Clinical Endocrinology recommends holding empagliflozin 72 hours before elective surgery [13].

Can I Get a Jardiance Prescription via Telehealth in Wisconsin?

Yes. Wisconsin law permits telehealth prescribing of empagliflozin for established patients, and the Ryan Haight Act exception enacted during the COVID-19 public health emergency has been extended through the end of 2025, allowing initial prescriptions via audio-video telehealth without a prior in-person visit [14].

A Wisconsin telehealth provider prescribing empagliflozin should complete a thorough medication history, confirm current kidney function (eGFR and creatinine), review HbA1c or heart failure documentation, and check for contraindications before issuing a prescription. The prescription must comply with Wisconsin s. 448.9725, which governs telehealth practice standards. Lab work can be ordered to a local LabCorp, Quest, or hospital outpatient draw center and reviewed asynchronously before the prescription is transmitted to pharmacy.

Telehealth prescribers in Wisconsin cannot prescribe controlled substances via audio-only encounters, but empagliflozin is not a controlled substance. Audio-only encounters can support prescription renewal with appropriate documentation when video is technically unavailable, under Wisconsin DHS telehealth guidelines.

What Is the Cheapest Way to Get Empagliflozin in Wisconsin?

The answer depends on insurance status and eligibility.

For commercially insured Wisconsin patients, the Boehringer Ingelheim/Lilly savings card at $10/month is almost always the lowest possible out-of-pocket cost for brand Jardiance. Patients should activate the card before the first fill.

For Wisconsin Medicaid enrollees, an approved PA results in $0 to $4/month cost. The priority task is getting the PA documentation submitted correctly the first time.

For uninsured or underinsured Wisconsin residents who do not qualify for Medicaid, compounded empagliflozin from a licensed 503A pharmacy is likely the lowest-cost legal option, sometimes available through telehealth membership programs at $0 to $80 per month. The Boehringer Ingelheim patient assistance program (PAP) is another path: patients below 400% of the federal poverty level may qualify for free brand Jardiance through the manufacturer's assistance program. Applications go through the prescribing provider's office.

Medicare Part D patients who qualify for Extra Help (Low Income Subsidy) pay $0 to $10.35 per month (2026 benchmark) for covered formulary drugs, which includes most Part D plan formularies that list empagliflozin.

A 2023 Health Affairs analysis found that copay assistance programs from SGLT2 inhibitor manufacturers reduced out-of-pocket costs by a mean of $1,340 per year for commercially insured patients who enrolled, compared to those who did not [15]. Enrollment, not eligibility, is the barrier. Most eligible Wisconsin patients simply do not activate the card.

Comparing Empagliflozin Costs Across Key Wisconsin Scenarios

Wisconsin patients rarely fit a single cost category. A 58-year-old Green Bay resident with employer insurance, an $1,800 deductible, and a Type 2 diabetes diagnosis faces a different cost trajectory than a 72-year-old Madison resident on Medicare Part D or a 34-year-old uninsured Appleton resident with newly diagnosed heart failure.

For the employer-plan patient: activate the savings card immediately. Before the deductible is met, the savings card caps the fill at $10/month. After the deductible is met, the plan copay (often $25 to $60) may be lower than the card maximum, so switching to the plan copay at that point is worth checking.

For the Medicare patient: apply for Extra Help through SSA.gov if household income is below $22,590 (individual) or $30,660 (couple) in 2026. Even outside Extra Help, compare Part D plan formularies annually during open enrollment (October 15 to December 7) because tier placement changes year to year.

For the uninsured patient: contact the prescribing clinic's social worker or care coordinator. Wisconsin has county-based pharmacy assistance programs, and several Federally Qualified Health Centers (FQHCs) in Wisconsin participate in the 340B drug pricing program, which can reduce brand Jardiance cost dramatically for qualifying patients.