For adults with chronic kidney disease in type 2 diabetes (CKD in T2D)
If you have a Medicare Part D plan, you’re in the right place to learn more about coverage for your KERENDIA prescription. Select an option below to see if your particular Medicare Part D plan covers KERENDIA, what you can do if your plan denies KERENDIA, how much your KERENDIA prescription might cost, and how to get help paying for your prescription.
See glossary for key Medicare terms.
Simply log in or create an account at medicare.gov/account/login to view your Medicare Part D plan and follow the instructions to check if KERENDIA is covered under your plan’s formulary. You can also call the number on the back of your prescription insurance card to ask if KERENDIA is covered.
If your insurance plan does not cover KERENDIA, your doctor can complete and submit a Letter of Medical Exception along with a Letter of Medical Necessity to request formulary coverage for you. Your doctor’s office can download sample letters at kerendiahcp.com/accessresources.
Some health insurance plans may require a prior authorization (PA) before KERENDIA can be approved. If your plan requires a PA for KERENDIA, your doctor will be asked to complete and submit the PA before you can pick up your prescription at the pharmacy.
If your plan denies the PA, an appeal may be submitted. Call your doctor’s office and ask to speak with the Benefits Manager. The Benefits Manager will make sure that the claim was submitted correctly or work with your doctor to appeal the decision on your behalf. Your doctor’s office can download a sample appeal letter on kerendiahcp.com/accessresources.
KERENDIA is covered by nearly all Medicare Part D plans, but the amount you pay each month may vary, depending on your specific plan and the time of the year. For example, you may pay more for your out-of-pocket costs until you meet your annual deductible.
BlinkRx is a digital pharmacy that looks for, and applies, eligible savings based on your insurance. After you register and check out, BlinkRx will also have your KERENDIA prescription delivered to your home with no delivery charge. You can ask your doctor to send your prescription to BlinkRx, or call 1-866-839-0766 for help transferring your prescription. Once your prescription has been transferred, you will receive a text message from BlinkRx with a link to register and pay for your prescription. Call 1-866-839-0766 or visit BlinkRx.com to learn more.
If you do not have insurance, your insurance plan does not cover KERENDIA, or you cannot afford your plan’s copay, you can choose to pay for your prescription yourself, without going through your insurance. KERENDIA is available for $99 per month* through BlinkRx. To use this option, ask your doctor to send your prescription to BlinkRx or call 1-866-839-0766 for help transferring your prescription. Once your prescription has been transferred, you will receive a text message from BlinkRx with a link to register and pay for your prescription, or you may complete the checkout process by phone. Call 1-866-839-0766 or visit BlinkRx.com to learn more.
*Terms and Conditions apply.
The programs below may help with the cost of your KERENDIA prescription.
Extra Help is a Medicare program that helps people with limited income and resources pay for their Medicare Part D drug coverage premiums, deductibles, coinsurance, and other costs. For people with Medicare Part D who also qualify for the Extra Help program, the cost for KERENDIA is $11.20 or less per month. Learn more about the Extra Help program or apply here.
Many states offer programs to help patients with their Medicare Part D premiums and copays. Visit this website and select your state to view the programs that may be available to you.
Private foundations and government programs may also offer financial assistance. This webpage from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) can help point you toward resources that may help you afford your prescription for KERENDIA.
If you cannot afford your prescription medication, Bayer may be able to help.
The Bayer US Patient Assistance Foundation is a charitable organization that helps eligible patients get Bayer prescription medicine at no cost. Please contact the program at 1-866-2BUSPAF (228-7723), Monday–Friday, 9:00 AM-6:00 PM ET, or visit the foundation website at www.patientassistance.bayer.us for information to see if you may qualify for assistance.
Find support on your terms. Connect one-on-one with a personal mentor, download the Medisafe™ app to set up reminders and track lab work, and sign up for onboarding emails to help guide your first few months on KERENDIA.
An appeal is something you and your doctor can do if you disagree with a coverage or payment decision made by your Medicare plan.
Also called copayment, this is the amount you may be required to pay for a medical service or supply, like a doctor’s visit or a prescription drug. A copay is usually a set amount, rather than a percentage. For example, you might pay $10 or $20 for a doctor’s visit or prescription drug.
The amount you are responsible to pay for healthcare or prescriptions before your healthplan begins to pay.
A type of Medicare prescription drug coverage determination in cases where a medication is not covered under the health plan’s formulary. If you would like to request an exception, your doctor or other prescriber must send a supporting statement explaining the medical reason for the exception.
Also known as Low Income Subsidy (LIS), this is a Medicare program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance.
A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits.
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).
Medicare Part A covers:
Part B covers physician visits, outpatient services, preventive services, and some home health visits. It also covers:
A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of your Part A and Part B benefits and most offer prescription drug coverage.
Part D is Medicare prescription drug coverage. These are optional benefits for prescription drugs available to all people with Medicare for an additional charge. This coverage is offered by insurance companies and other private companies approved by Medicare.
Healthcare or prescription drug costs that you must pay on your own because they aren’t covered by Medicare or other insurance.
The monthly payment to Medicare, an insurance company, or a healthcare plan for health or prescription drug coverage.
A state program that provides help paying for drug coverage based on financial need, age, or medical condition.
Medicare is available to patients ages 65 and older, as well as those under 65 with certain health conditions. Medicare Part D drug coverage is optional and offered to everyone with Medicare. Therefore, you must have Medicare Part A and/or Part B first to join a separate Medicare Part D drug plan. Please note that you will pay an additional cost on top of what you pay for Medicare Parts A and B if you sign up for Medicare Part D. Learn more about signing up for Medicare.
While it’s optional to elect a Medicare Part D plan for prescription drug coverage, it’s important to sign up for Medicare Part D when you are first able to, even if you don’t take prescription medicine. If you do not sign up for Medicare at this time, you may pay a late fee. This late fee is permanent and can increase over time, so remember to sign up for Medicare Part D as soon as you can.
You can sign up for Medicare between 3 months before your 65th birthday and during the 3 months that follow your 65th birthday.
After you sign up for Medicare, you can change your plan each year during the Open Enrollment Period. The Open Enrollment Period is between October 15 and December 7 of each year.
If you signed up for a Medicare Advantage plan, you can change your plan during the Medicare Advantage Open Enrollment Period, which is between January 1 and March 31 of each year.
Visit www.ssa.gov/benefits/medicare or contact the Social Security Administration to sign up.
You can check your plan to find out which drugs are covered before you choose your Part D coverage. Your plan’s formulary may change throughout the year so be sure to keep up to date to make sure your medicine is still covered.
Formularies may include levels called “tiers,” where medicine is categorized based on the costs you will pay. Formularies may also include coverage rules (eg, prior authorization, step therapy) that can require you and your doctor to go through extra steps before your medicine is covered by your insurance.
If your medication is not covered, subject to a coverage rule, or is covered on a higher, more expensive tier, you and your doctor can work together to request an exception from Medicare and make your medication more affordable.
Yes, but your drug costs can vary based on which pharmacy you use. Out-of-pocket costs may be less at a pharmacy that is preferred by your drug plan or when prescriptions are filled by a mail-order pharmacy.
Medicare Part D has different phases. Depending on the phase of coverage you are in, you may pay a different out-of-pocket cost when you pick up your medicine from your pharmacy.
Most Part D plans do not follow the structure listed above. Medicare requires that health plans offer equal or better coverage than what is included above.
KERENDIA is a prescription medicine used to treat chronic kidney disease in adults with type 2 diabetes to reduce the risk of:
Please see the Prescribing Information for KERENDIA.
