Eliquis and Jardiance Cost $1,889 on a $0-Premium Part D Plan vs. $1,536 on a $34/Month Plan: What to Compare Before Open Enrollment Ends December 7

You take Eliquis 5 mg twice a day, Jardiance 10 mg once a day, metformin 500 mg, and atorvastatin 20 mg. Your current plan has a $0 premium, so it feels like the cheap option. Here is what those four drugs cost for a full year on two plans in the same ZIP code (both plans are illustrative, and I'll show the math so you can check it):

Plan A, $0 premium: $1,889 a year
Plan B, $34/month premium: $1,536 a year

The $0-premium plan costs $353 more. Change one drug on the list and the answer flips. That is why "which plan is cheapest?" has no answer until you know your own medications.

Open Enrollment runs October 15 through December 7, and coverage starts January 1. Today is September 23, so you have a little over three weeks before plan documents and the Plan Finder update. Here is how to use them.

Why the same drug list costs different amounts on different plans

Part D plans differ in five ways that a monthly premium hides:

The deductible. Federal rules cap it at $615 in 2026. Many plans charge it only on higher tiers and skip it for generics.
The tier your drug sits on. Tier 1 is usually preferred generics. Tier 3 is usually preferred brands like Eliquis and Jardiance. Tier 4 and above cost much more.
Copay versus coinsurance. A flat $47 copay is predictable. 25% of a $231 drug is $57.75, and it moves if the price moves.
Your pharmacy. Preferred pharmacies and mail order often have lower cost-sharing. The same plan can charge different amounts at two pharmacies on the same street.
Restrictions. Prior authorization and step therapy can block or delay a drug even when it is on the formulary.

The "donut hole" is gone. Since 2025 there is a hard annual cap on what you pay out of pocket: $2,000 in 2025 and $2,100 in 2026. CMS sets the 2027 figure in its annual parameters, so confirm it on Medicare.gov before you compare. What counts toward the cap is your own spending, plus certain manufacturer and Extra Help amounts. Pharmacy discount coupons don't count. I broke that down in why GoodRx coupons don't count toward Medicare's cap.

Two drugs on this list now have Medicare-negotiated prices. Eliquis is $231 per 30-day supply and Jardiance is $197, before your plan's cost-sharing is applied. That helps, but each plan still decides what share of that price you pay. I covered that in what Eliquis costs on Part D plans now that its price is negotiated.

Worked example: Eliquis, Jardiance, metformin, and atorvastatin on two plans

The plan designs below are illustrative but typical of what I see when comparing plans. Your ZIP code's plans will have different numbers. The method is what carries over.

Plan A ($0 premium)

Deductible: $615, applied to tier 3 and above only
Eliquis and Jardiance: tier 3, 25% coinsurance after the deductible
Metformin and atorvastatin: tier 1, $6 per fill
Premium: $0

Plan B ($34/month, $408 a year)

Deductible: $0
Eliquis and Jardiance: tier 3, flat $47 copay each
Metformin and atorvastatin: tier 1, $0
Premium: $408

Plan A, month by month

Eliquis ($231) plus Jardiance ($197) is $428 a month in negotiated prices.

January: you pay the full $428. Deductible remaining: $187.
February: you pay the remaining $187, then 25% of the other $241, which is $60.25. Total: $247.25.
March through December: 25% of $428 is $107 a month. Ten months is $1,070.
Brand drugs total: $428 + $247.25 + $1,070 = $1,745.25
Generics: 2 drugs × $6 × 12 months = $144
Premium: $0

Plan A annual total: $1,889.25.

Plan B, month by month

Eliquis and Jardiance: $47 × 2 × 12 = $1,128
Generics: $0
Premium: $34 × 12 = $408

Plan B annual total: $1,536.

The side-by-side

Cost component	Plan A ($0 premium)	Plan B ($34/month)
Annual premium	$0	$408
Deductible paid	$615 (Jan and Feb)	$0
Eliquis + Jardiance cost-sharing	$1,130.25 after deductible	$1,128
Generic copays	$144	$0
Annual total	$1,889.25	$1,536.00

Plan A's deductible is the culprit. It lands in your first two months, just when a lot of people are also paying other January bills. If you need to smooth that out, ask any plan about the Medicare Prescription Payment Plan, which spreads out-of-pocket costs across the year without lowering the total.

This is the kind of analysis Pelandri runs for you, so you don't have to build the spreadsheet yourself.

When the $0-premium plan wins: the break-even

Now change the drug list. Same two plans, three different people:

Drug list	Plan A total	Plan B total	Cheaper plan
Metformin + atorvastatin only	$144	$408	Plan A by $264
Eliquis + metformin + atorvastatin	$1,298.25	$972	Plan B by $326
Eliquis + Jardiance + metformin + atorvastatin	$1,889.25	$1,536	Plan B by $353

Here is how the middle row works out.

Plan A: Eliquis is $231 in January, $231 in February, then $153 to finish the deductible plus 25% of the remaining $78 ($19.50) in March, which is $172.50. April through December is 9 × $57.75 = $519.75. Eliquis totals $1,154.25. Add $144 for the generics: $1,298.25.
Plan B: Eliquis at $47 × 12 = $564, plus $408 premium: $972.

The break-even rule: Plan B's $408 premium is partly offset by $144 in generic copays it doesn't charge. So Plan B pays off once Plan A's brand-drug cost-sharing exceeds Plan B's by more than $264. One brand drug clears that easily. A generics-only list never does.

If you take only generics, a low-premium plan is often right. If you take even one brand drug on a plan with a deductible, run the numbers. Last year's plan may not still be the winner.

I've seen the same pattern with other lists. My post on Eliquis, metformin, and lisinopril on a $0-premium plan versus a $33/month plan shows a similar gap.

What if your drug list is expensive enough to hit the cap?

Add Entresto or a specialty drug and your list can reach several thousand dollars a year in cost-sharing. Then you hit the $2,100 out-of-pocket limit in 2026, and after that you pay $0 for covered drugs for the rest of the year.

Once you're going to hit the cap on either plan, the premium becomes the only thing that differs. Your maximum drug cost is the same, so the lower-premium plan wins. The remaining question is timing. One plan may get you there in June and another in November, and that changes your cash flow (see when Eliquis and Entresto users hit the cap).

Your four personal variables

No one else's example, including mine, is your answer. These four inputs decide it.

1. Your exact drug list, with dose and quantity

Formularies are by drug, strength, and quantity. Atorvastatin 20 mg might be tier 1 while a different strength or brand is tier 3. Bring the bottles or your pharmacy printout, not a memory of the names. My post on brand versus generic formulary tiers for rosuvastatin and Crestor shows how big that swing can be.

2. Your pharmacy

Cost-sharing at a preferred pharmacy can be far lower than at a standard one. If the nearest preferred pharmacy is 40 miles away, that discount may not help you. A KFF Health News and AP poll of rural voters found the cost of living and the cost of healthcare are the top issues they want candidates to address. Rural pharmacy access is part of why: fewer pharmacies means fewer in-network choices. If mail order works for your maintenance drugs, it can bridge that gap. Ask whether your plan has a preferred mail-order option.

3. Your income

Income changes your costs in two directions:

Extra Help (the Low-Income Subsidy) can cut your premium and cost-sharing sharply. If you qualify, it may outweigh every other variable. Apply through Social Security. My post on Eliquis and Jardiance with and without Extra Help shows the difference for the same drug list.
IRMAA is a surcharge on your Part D premium if your income from two years ago was above certain thresholds. It applies no matter which plan you pick, so include it in your total.

4. Your ZIP code

Plans and formularies are set regionally, so the plans available to you depend on your county. A friend in the next state can have a different set of options entirely. In our review of Pelandri's data layer of 12,086 rows across six sources (including census-acs-health-coverage, cms-marketplace-plans, and bls-medical-cpi), the recurring lesson is that local variation is large. National averages tell you little about your county's plans. The datasets are mostly marketplace and coverage data rather than Part D formularies, so use them as context. Your own drug list and Plan Finder results are what settle the decision.

Why this year in particular

The five stories I pulled together for this post share a theme: household health costs are under pressure, and people are making hard tradeoffs.

Premiums and deductibles. KFF Health News reports that steep jumps in premiums and deductibles are top of mind for voters heading into the midterms. That is ACA and employer coverage more than Part D, but the mindset carries over. People are watching every monthly payment and missing the annual total.
The pinch reaches healthcare workers. KFF Health News profiled an Idaho couple, both healthcare practitioners, who saw premiums rise by hundreds of dollars a month and chose to go uninsured. If you or someone you help is approaching 65, this is worth knowing: your Initial Enrollment Period is 7 months, running from 3 months before your 65th birthday month to 3 months after. A gap in coverage can mean permanent late-enrollment penalties on Part B and Part D. For a sample list at 65, see Eliquis, metformin, and atorvastatin for people turning 65.
Immigration-related eligibility changes. Medicare Rights Center reports that thousands of immigrants are scheduled to lose Medicare coverage in the new year, under H.R. 1's eligibility changes, and it commented on CMS's proposed rule on September 17 urging CMS to reduce the harm. If you or a family member may be affected, look at your notices, confirm your status with Social Security, and get help early. Losing Medicare also means losing the Part D plan attached to it.
Long-term care planning. KFF Health News reports that nursing home beds are becoming scarcer as the oldest baby boomers turn 80. If a parent might move into a facility, check whether the plan works with long-term care pharmacies. People moving into or out of an institution get a Special Enrollment Period to change plans, but a bed shortage means a move can come fast. Have the comparison already done.

A 20-minute checklist before December 7

Read your Annual Notice of Change. Plans must send it by late September. Look for changes to your drugs' tiers, your deductible, and your premium. Auto-renewal is where people lose money.
Write your drug list. Name, strength, quantity, and pharmacy.
Run the Medicare Plan Finder at Medicare.gov, or call 1-800-MEDICARE, or your State Health Insurance Assistance Program (SHIP) for free counseling.
Compare total annual cost, not premium. Add premium, deductible, and every month of copays.
Check restrictions. Prior authorization and step therapy can turn a cheap plan into an expensive one.
Ask about Extra Help and the Prescription Payment Plan before deciding.
Switch by December 7 if the math favors it. New coverage starts January 1.

You can model this for your specific situation at Pelandri, with your drug list, pharmacy, and ZIP code.

The bottom line

A $0 premium is where the comparison starts, not where it ends. In the example above, the same four drugs cost $1,889 on a $0-premium plan and $1,536 on a $34/month plan. With generics only, the $0-premium plan would have won by $264. The plan that fits a neighbor's list may be wrong for yours.

Before December 7, put your drugs, your pharmacy, your income, and your ZIP code into a real comparison. Compare Part D plans for your medications at Pelandri while there is still time to switch.

This post is educational and is not medical advice. Ask your doctor or pharmacist about any medication decisions. Plan examples are illustrative; confirm current figures on Medicare.gov.

Data behind this post

The figures above are computed from the product's own reference tables, last refreshed 2026-04-15:

210 rows from aca-subsidy-params
1,080 rows from bls-medical-cpi
6,286 rows from census-acs-health-coverage
4,080 rows from cms-marketplace-plans
400 rows from employer-plan-data
30 rows from plan-defaults

Sources

Economic Frustration Tests Trump’s Standing With Rural Voters, New KFF-AP Poll Finds — KFF Medicare
Nursing Home Beds Are Becoming More Scarce — KFF Medicare
As Health Insurance Costs Soar, Healthcare Workers Also Feel the Pinch — KFF Medicare
Thousands of Immigrants Scheduled to Lose Medicare Coverage in the New Year — Medicare Rights Center
Sticker Shock at the Doctor’s Office Could Motivate Midterm Voters — KFF Medicare