Manufacturer patient assistance
Boehringer Cares Patient Assistance Program
Boehringer Ingelheim Cares Foundation
Status: Jardiance is listed in BI's 2026 eligibility guidelines (dated January 2026) and on the program application. BI's website blocked our automated verification on August 26, 2026, so we could not confirm the program is accepting applications today — call 1-800-556-8317 (Monday–Friday, 8:30 am–6:00 pm ET) before you apply.
Boehringer Ingelheim's foundation provides Jardiance free of charge to eligible patients — one of the manufacturer programs that still accepts Medicare Part D enrollees. Applying is free.
If you have Medicare: BI's rules: you may apply if you are uninsured, or if you have Medicare but cannot afford your medication and you do not qualify for Medicare's Extra Help (Low-Income Subsidy). BI may ask for proof of an Extra Help denial. Medicare Part D enrollments approved between October 15 and December 31 run through the end of the following year (up to 15 months).
What it can cover: Jardiance at no cost for approved patients for the enrollment period (12 months, or through the following December 31 for late-year Medicare approvals).
Who may qualify
- U.S. resident treated as an outpatient by a U.S.-licensed provider
- Uninsured, or your insurance does not cover Jardiance, or you have Medicare Part D but cannot afford it and do not qualify for Extra Help
- Household income at or below 250% of the federal poverty level (Group 2 medicines): $39,900 for one person, $54,100 for two, $68,300 for three, $82,500 for four in 2026 (48 states; higher in Alaska and Hawaii)
- No access to other coverage or funding for the medication; not in an employer "alternate funding" program that requires applying to manufacturer programs
What the application asks for
- Patient sections: product, patient information, household size and total annual income, insurance information (Medicare Part D checkbox), whether you have an Extra Help denial letter (attach it if so), signed patient attestation
- Prescriber sections: prescriber information and signed attestation, plus a prescription (on the form, faxed separately, or sent electronically to the program pharmacy)
- BI may request proof of income — federal tax return, W-2, 1099, pension or Social Security statement, pay stubs — and proof of Extra Help denial
How to apply
You complete the patient sections and sign; your prescriber completes and signs the prescriber sections and supplies the prescription. Fax the application to 1-866-851-2827 or mail it to Boehringer Cares Patient Assistance Program, PO Box 99055, Jeffersontown, KY 40296. There is no charge to apply.