Jardiance

Indicated For

T2D, HFrEF, CKD

About This Medication

# Boehringer Cares Patient Assistance Program: How to Get Jardiance at Low or No Cost ## About This Program The **Boehringer Cares Patient Assistance Program** provides Jardiance (empagliflozin) and other Boehringer Ingelheim medications **free of charge** to eligible U.S. patients who cannot afford their prescriptions. This program is designed to ensure that financial barriers don't prevent you from accessing the medications you need to manage your health. ## About Jardiance Jardiance is a prescription medication used to help control blood sugar levels in people with type 2 diabetes. It works by helping your kidneys remove excess sugar through urine. Your healthcare provider has determined that Jardiance is an appropriate treatment for your condition. ## Who Qualifies for This Program? You may be eligible for the Boehringer Cares Patient Assistance Program if you meet **all** of the following requirements: - **Residency**: You are a resident of the United States or a U.S. territory with a valid physical address - **Insurance Status**: You have one of these coverage situations: - No health insurance coverage at all - Health insurance that doesn't adequately cover prescription medications - Medicare Part D coverage but difficulty affording your drug costs - Medicaid or commercial insurance with high out-of-pocket costs - **Income**: Your household income falls within the program's guidelines (typically based on Federal Poverty Level thresholds) - **No Alternative Coverage**: You don't have access to other prescription drug assistance programs or funding sources - **Valid Prescription**: You have a current prescription for Jardiance from a licensed healthcare provider ## Income Eligibility Guidelines The program uses **Federal Poverty Level (FPL) guidelines** to determine income eligibility. While specific income thresholds are not publicly listed, the program typically allows patients at or below 200-400% of the Federal Poverty Level, depending on household size. Your actual eligibility will be determined during the application review process. | Household Size | Approximate FPL (2026) | Typical Program Threshold (200-400% FPL) | |---|---|---| | 1 person | ~$15,000 | ~$30,000–$60,000 | | 2 people | ~$20,000 | ~$40,000–$80,000 | | 3 people | ~$25,000 | ~$50,000–$100,000 | | 4 people | ~$30,000 | ~$60,000–$120,000 | *Note: These are approximate figures for reference only. Contact the program directly for exact current thresholds.* ## Insurance Requirements The program serves patients with various insurance situations: - **Uninsured patients**: Those with no health insurance - **Underinsured patients**: Those with insurance that doesn't adequately cover prescriptions or has high copays - **Medicare patients**: Some Medicare Part D beneficiaries who have difficulty affording their drug costs and don't qualify for other assistance - **Medicaid patients**: Those with Medicaid coverage but still facing affordability challenges - **Commercially insured patients**: Those with private insurance but high out-of-pocket costs **Important**: You must not have access to other prescription drug coverage or assistance programs. The program will verify your insurance status and investigate other available resources. ## How to Apply: Step-by-Step ### Step 1: Gather Required Documents Before starting your application, collect: - Proof of income (recent tax return, pay stubs, Social Security statement, or unemployment documentation) - Current insurance information (if applicable) - Your prescription for Jardiance - Proof of residency (utility bill, lease, or government ID) ### Step 2: Complete the Application You have two options: **Option A: Apply Directly** - Contact the program at **(800) 556-8317** (Monday–Friday, 8:30 AM–6:00 PM ET) to request an application form - Complete Sections 1-4 of the application with your personal, financial, and insurance information - Have your healthcare provider complete Sections 5-6, which confirm your diagnosis and prescription **Option B: Apply Through a Patient Advocate Service** - Use services like Simplefill that help connect you with the program - A patient advocate will interview you about your medical conditions, financial circumstances, and insurance - They will handle the application process on your behalf ### Step 3: Submit Your Application Submit your completed application along with proof of income and your healthcare provider's signature by: - **Fax**: 1-866-851-2827 - **Mail**: Boehringer Cares Patient Assistance Program, PO Box 99055, Jeffersontown, KY 40296 Make sure your healthcare provider signs the form—applications without a provider signature are incomplete. ### Step 4: Wait for Approval The program will review your application according to BI Cares eligibility criteria. They will verify the information you provided, check your insurance benefits, and determine if you qualify. If you don't meet the requirements or if information is missing, they will contact you. ### Step 5: Receive Your Medication Once approved, your Jardiance will be **shipped directly to your address** at no cost. Medication is typically delivered to the address you provide on your application unless you specify otherwise. ## Timeline and Delivery - **Processing Time**: The exact processing timeline is not specified by the program, but applications are typically reviewed within 1-2 weeks - **Delivery Method**: Medications are shipped directly to your home address - **Reauthorization**: Your eligibility must be **reauthorized periodically**—the program will contact you when renewal is needed ## What If Your Application Is Denied? If you don't qualify for the Boehringer Cares program, the program staff may: - Identify other patient assistance resources you might qualify for - Explain which eligibility requirements you didn't meet - Suggest alternative options, such as: - Manufacturer coupons or discount programs - State pharmaceutical assistance programs - Non-profit organizations that help with medication costs - Discussing generic alternatives with your healthcare provider ## Important Reminders - **Reauthorization Required**: Your eligibility is not permanent. You will need to reauthorize your participation periodically - **Income Verification**: Be prepared to provide proof of your household income - **Provider Signature**: Your healthcare provider must sign the application—you cannot submit it without their signature - **No Other Coverage**: You cannot have access to other prescription drug assistance programs - **Residency**: You must have a valid U.S. address for medication delivery ## Contact Information **Boehringer Cares Patient Assistance Program** - **Phone**: (800) 556-8317 - **Hours**: Monday–Friday, 8:30 AM–6:00 PM ET - **Fax**: 1-866-851-2827 - **Mailing Address**: PO Box 99055, Jeffersontown, KY 40296 ## Disclaimer This guide provides general information about the Boehringer Cares Patient Assistance Program. Program eligibility, requirements, and benefits may change. For the most current and accurate information, contact the program directly at the phone number or address listed above. This information is not a guarantee of eligibility or approval. Always consult with your healthcare provider about your treatment options.

Program information last verified: March 30, 2026