Januvia® Medicare Coverage

Januvia®
Chemical name: Sitagliptin

Typical dosage: 100mg

Typical type: Tablet1

Januvia® is a medication used to treat type 2 diabetes. It is currently available as brand name only and comes in the form of an oral tablet.

Januvia is a prescription medication that contains the active ingredient Sitagliptin. Januvia is typically taken once daily and may be combined with insulin or other oral anti-diabetic medications.

Januvia is a DPP-4 inhibitor that stimulates the pancreas to secrete more insulin and stops the liver from producing sugars when blood sugar is high.

The major side effects of Januvia include headache, signs of a common cold, sore throat, stuffy nose and runny nose.

Does Medicare cover Januvia?

Yes! 95% of Medicare Advantage plans and Medicare Part D plans cover Januvia.1

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.2

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Januvia.

Find Medicare Advantage plans with drug coverage

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

 

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Average costs for Januvia with Medicare drug coverage1

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.
$42 – $519 $19 – $519

Additional information

Januvia should be used along with proper diet and exercise to treat high blood sugar levels caused by type 2 diabetes. This medication may be given in combination with other drugs to adequately control your diabetes.

Patients who are 65 years of age and older may experience more side effects. Agents other than Januvia are considered safer in women who are pregnant and breastfeeding who require oral anti-diabetic therapy.

Patients taking Januvia sometimes experience joint pain that may occur within one day to years after starting treatment. This may be resolved by stopping Januvia therapy.

Other serious conditions such as blistered skin, heart failure and kidney problems have occurred in patients taking Januvia. Call your doctor immediately if you experience blisters or skin breakage, shortness of breath, noticeable weight gains or swelling in the arms and legs.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.