Medicare 2026

Diabetes Drugs With Medicare Negotiated Prices: What Jardiance, Farxiga, Januvia and More Will Cost

If you take medication for type 2 diabetes, you've probably heard that Medicare has started negotiating prices on some of the most widely used brand-name drugs. That negotiation is now showing up at the pharmacy counter — and more diabetes drugs are joining the list in 2027. Here's a plain-English look at what's changing, what it means for your out-of-pocket cost, and how to think about your Part D coverage during this fall's Annual Enrollment.

What the "negotiated price" actually is

Under current Medicare Part D rules, the federal government negotiates prices on a growing list of brand-name drugs. The law calls the result a "maximum fair price" — the amount the drug company must make the medication available at to people with Medicare and to the pharmacies that dispense it.

A key point that trips people up: the negotiated price is not what you pay at the counter. Your share still depends on your plan's deductible, which tier the drug sits on, and the plan's cost sharing. What the negotiated price does is lower the underlying cost that your plan's math is built on, which generally pulls member cost sharing down over time.

By law, stand-alone Part D plans and Medicare Advantage plans that include drug coverage must put these negotiated drugs on their formularies. Once a drug is in the program, its negotiated price stays in effect and is adjusted each year after the first by the change in the Consumer Price Index (CPI-U). CMS publishes the updated prices.

The 2026 list: already in effect

Since January 1, 2026, these 30-day prices are in place (compared with the 2023 list price):

• Jardiance (empagliflozin): $197 (list $573)
• Farxiga (dapagliflozin): $178.50 (list $556)
• Januvia (sitagliptin): $113 (list $527)
• Fiasp and NovoLog insulins: $119 (list $495)

Remember that for any Part D-covered insulin, your cost at the pharmacy is capped at $35 for a month's supply, and the Part D deductible does not apply to insulin. That's been true since 2023.

The 2027 additions

Starting January 1, 2027, more diabetes medications join the negotiated-price list. These 30-day prices are compared with the 2024 list price:

• Tradjenta (linagliptin): $78 (list $488)
• Janumet and Janumet XR (sitagliptin/metformin): $80 (list $526)
• Ozempic and Rybelsus (semaglutide): $274 (list $959)

A note on Ozempic and Rybelsus: Medicare covers semaglutide when it's prescribed for type 2 diabetes. Coverage for weight loss alone is a separate question governed by your plan's rules.

How this fits with the 2027 Part D structure

A few program-level numbers to keep in mind for 2027:

• The Part D out-of-pocket cap rises to $2,400 (it is $2,100 in 2026). Once your true out-of-pocket drug spending hits that cap, you pay $0 for covered Part D drugs the rest of the year.
• The maximum Part D deductible any plan may charge in 2027 is $700. Plans can set a lower deductible or none at all.
• The Part D base beneficiary premium for 2027 is $41.33. That's a national figure used to calculate the late-enrollment penalty; actual plan premiums are set plan by plan.
• Social Security announced a 3.6% COLA for benefits payable beginning January 2027.

The 2027 Part B standard premium and deductible, and the IRMAA income brackets, had not been announced at the time this was written. CMS typically releases those figures in the fall (usually November). Check Medicare.gov for the official numbers once they're posted.

Choosing coverage: Original Medicare vs. Medicare Advantage

Negotiated prices apply across the Part D program, but how you access drug coverage still comes down to the path you choose:

• Original Medicare + a stand-alone Part D plan (often paired with a Medigap policy): broad provider access nationwide, more predictable medical cost sharing with Medigap, but separate premiums for Part D and Medigap.
• Medicare Advantage with drug coverage: often bundles medical and drug coverage with extra benefits and network rules, with cost sharing that varies by service.

Neither path is "better" — the right fit depends on the drugs you take, your providers, your travel patterns and your budget. During Annual Enrollment (October 15 – December 7, 2026), you can compare plans side by side using the Plan Finder on Medicare.gov.

If you have Medicaid or Extra Help

Since 2025, people with full Medicaid or Extra Help have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible people can join an integrated D-SNP in any month. You don't have to wait for Annual Enrollment to make these changes.

What does this mean for people with Medicare?

Negotiated prices on Jardiance, Farxiga, Januvia and the insulins are already in effect, and Tradjenta, Janumet, Janumet XR, Ozempic and Rybelsus follow in 2027. These prices lower the underlying cost that plans build their cost sharing on, but what you actually pay still depends on your specific Part D plan. The $2,400 out-of-pocket cap and the $35 insulin cap give you two important ceilings.

For official information and to compare plans, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24/7.