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Is Baqsimi covered by Medicare?

Medically reviewed by Carmen Pope, BPharm. Last updated on May 14, 2024.

Official answer

by Drugs.com
  • For most people, Medicare does not cover the cost of Baqsimi.
  • Some Medicare patients can qualify for financial support through the Extra Help program.
  • Without any insurance coverage, Baqsimi costs around $305 for a single-dose, single-use, nasal powder spray, according to the Drugs.com price guide.
  • People with commercial drug insurance coverage that covers Baqsimi may be eligible for the Baqsimi Got Your BAQ™ savings card which means they may pay as little as $25 for up to 2 Baqsimi devices (conditions apply).
  • There is currently no generic form of Baqsimi.

Related: Drugs.com Pricing, Online Coupons and Manufacturer’s Savings

What is Baqsimi?

Baqsimi (glucagon nasal powder) may be used to treat severe hypoglycemia (low blood sugar/glucose levels) in adults and children over the age of four. Glucagon is a hormone that increases blood glucose levels by stimulating the release of glucose from the liver. It also slows digestion.

Does Medicare cover Baqsimi?

Medicare is the federal health insurance program for people aged 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Different parts of Medicare help cover specific services with Medicare Part D covering prescription drug coverage.

  • Medicare-eligible beneficiaries can enroll in a Medicare Part D Prescription Drug plan from a private insurance company.
  • Out of pocket costs for Baqsimi depend on your insurance company and what phase of the Part D benefit you are currently in.
  • For the majority of people, Medicare does not cover the cost of Baqsimi.
  • Some Medicare patients can qualify for financial support through the Extra Help program.

The Lilly Diabetes Solution Center (1-833-808-1234) can offer advice on the most affordable option for each individual.

People with commercial drug insurance coverage that covers Baqsimi may be eligible for the Baqsimi Got Your BAQ™ savings card. They may pay as little as $25 for up to 2 BAQSIMI devices (1 two-pack or 2 one-packs) with a maximum of 12 fills per year. This offer is capped and expires at the end of each calendar year (maximum of 12 fills per year). The patient is responsible for any taxes, fees, or amounts exceeding monthly or annual caps.

According to the Drugs.com price guide which bases its price on the Drugs.com discount card which is accepted at most U.S. pharmacies, the cost for a single-dose Baqsimi nasal powder 3mg is approximately $305 depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

Baqsimi is a dry nasal spray that is given for low blood sugar emergencies to people who cannot eat, have passed out, or are having a seizure due to low blood sugar levels (hypoglycemia). Hypoglycemia needs to be treated as quickly as possible because having low blood sugar levels for too long can cause seizures, coma, or death.

Each Baqsimi device contains 1 dose of glucagon nasal powder and cannot be reused. There is currently no generic version of Baqsimi.

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