Key takeaways

Eliquis, an anticoagulant medication used to treat and prevent blood clots and stroke, is covered by Medicare Part D. Though the exact costs vary by plan, the monthly copay averages $55, with some patients paying $40 or less.
Medicare Part D covers Eliquis. It is also covered in inpatient settings under Part A and Part C if Eliquis is on the formulary but not under Part B (outpatient services).
Medicare plans may require prior authorization and step therapy for Eliquis coverage. Though these requirements may delay treatment start, they ensure that cheaper alternatives are considered first.
Savings strategies for Eliquis include using SingleCare coupons, Medicare Extra Help, manufacturer rebates, and financial assistance programs, obtaining free samples from doctors, comparing prices at local pharmacies, and considering alternative medications.

Does Medicare cover Eliquis? | How much does Eliquis cost with Medicare? | Eliquis assistance for Medicare patients

Eliquis (apixaban) is an FDA-approved anticoagulant (blood thinner). Eliquis is part of a class of anticoagulant drugs called direct factor Xa inhibitors that work by neutralizing the effects of enzymes that form blood clots. This helps reduce the chance of forming life-threatening blood clots and lowers the risk of stroke.

According to Alain Tanbe, MD, a fellowship-trained, board-certified vascular surgeon at The Vascular Center at Mercy Medical Center, Eliquis treats and prevents several vascular conditions. Eliquis is used to:

Treat deep vein thrombosis (DVT) or pulmonary embolism(PE)
Treat certain heart conditions like atrial fibrillation (AFib)
Prevent blood clots mainly after orthopedic procedures
Prevent or treat ischemic stroke

Eliquis may be prescribed as a long-term therapy or as a “bridge” therapy to help you recover from a recent surgery or procedure. Because it’s often taken twice daily, the cost may be high and burdensome for many patients—including those on Medicare. Fortunately, Eliquis coupons for Medicare consumers and people without a health insurance plan are available to reduce or eliminate the cost of this medication.

RELATED: Eliquis side effects

Does Medicare cover Eliquis?

Those with Medicare healthcare coverage may wonder if their plan covers Eliquis. Medicare provides different options for prescription coverage through its plans, and it may not be available to every patient with a Medicare plan.

Medicare has four different parts that cover different services:

Medicare A may cover Eliquis when administered in an inpatient setting, such as during a hospital stay.
Medicare Part B covers outpatient services and therefore does not cover Eliquis.
Medicare Part C will cover Eliquis if it is administered in an inpatient setting (see Part A above) or if the Part C plan includes prescription drug coverage and it is on the plan’s formulary (see Part D below).
Medicare Part D covers prescription medications that are taken at home. It is the most likely part of Medicare to cover your Eliquis prescription if it is included in your plan’s drug formulary.

In general, Medicare Part D plans, also known as the prescription drug benefit, cover Eliquis. You’ll be responsible for your monthly premiums and yearly deductible, as well as copays for your prescription medicines.

For 2025, the maximum deductible for Part D coverage is $590. This means that you’re responsible for up to your first $590 in prescription drug costs before coverage becomes available. Your annual deductible is based on your income and could change each year.

If you do not have Part D coverage, you can add it during Open Enrollment or during a Special Enrollment Period, but a late enrollment penalty may apply in some instances.

How much does Eliquis cost with Medicare?

The cash price of a 30-day supply of Eliquis is typically between $700 and $800 without insurance coverage. However, those on Medicare can access a discounted rate through their Part D plan. On average, the monthly copay for Eliquis with Part D coverage is $55, according to the drug manufacturer’s site. The site also states that roughly half of people taking Eliquis who also have Medicare coverage pay $40 or less for the drug each month.

Prior authorization

Since the medication is expensive and a brand-name-only drug, your doctor may have to submit the proper paperwork to your plan prior to your pharmacy dispensing it. This is known as a prior authorization, which requires your plan to “pre-approve” the medication before you can begin taking it. Once your plan approves, you should be able to get your medication at a discounted price.

Step therapy

Your plan may also require you to first try one or more other medications before seeking coverage for Eliquis. This is known as step therapy. Step therapy protects your plan by ensuring that you’ve tried cheaper alternative medications before moving on to newer treatments.

The pharmacy will notify your doctor if prior authorization or step therapy is required. You can also see if step therapy is required by reviewing your specific plan using the medicare.gov Plan Finder tool. Your doctor will then submit the proper documents to request that your insurance company cover the medication. Prior authorization should take a maximum of a couple of hours as long as the system is working correctly. However, the step therapy process can take anywhere from a couple of weeks to a few months, so you may need to be patient before receiving coverage and starting treatment.

Eliquis assistance for Medicare patients

Many medications offer a generic form or alternative to Eliquis with a lower cash price or copay, which can help bring down your treatment costs. According to the FDA, a generic drug is a copy of a brand-name drug that’s marketed once the original patent has expired. Because of competition, these may cost you less out-of-pocket compared with their name-brand alternative.

The FDA approved a generic version of Eliquis in 2019, but it won’t be available until November 2026 because of the current patent status. Once available, the generic version (apixaban) will likely have a reduced price that will make Eliquis a less costly treatment option for those currently on the medication.

There are other ways you can save money on Eliquis. Some of these options, such as manufacturer copay cards and coupons, are short-term savings tools. But there are also some long-term strategies ‌to consider.

Some of the best ways to save on Eliquis include:

Use SingleCare prescription savings: SingleCare offers discounts on many medications, including Eliquis. Anyone in the U.S. can use free Eliquis coupons at participating pharmacy locations around the country regardless of insurance or Medicare status. A 30-day supply of Eliquis costs as little as $467 with SingleCare.
Medicare Extra Help: Those who qualify for Medicare Extra Help may ‌pay as little as $0 on some medications, including Eliquis. The Extra Help program is available to those on Medicare who have limited income and resources.
Manufacturer rebates: Eliquis coupons may be available to eligible patients through the manufacturer. Contact Bristol-Myers Squibb to find out if you qualify.
Financial assistance programs: The Bristol-Myers Squibb Patient Assistance Foundation offers a program that can help eligible Eliquis patients pay out-of-pocket costs. Visit the Eliquis site for eligibility requirements.
Free samples at doctor’s offices: You can request a free sample from your prescriber. This isn’t a long-term solution, but if you’re in a bind and need an Eliquis refill fast, ‌ask about the availability of samples. This strategy can get you by while applying for a patient assistance program or while waiting for prior authorization from Medicare.
Compare Eliquis prices at local pharmacies: More often than not, you can save money on Eliquis by shopping around for a better price.
Eliquis alternatives: There are substitutions available. If the cost is too high, talk to your doctor about other available drugs that can help manage your condition. Some other options include Xarelto (rivaroxaban), Pradaxa (dabigatran), Savaysa (edoxaban), and warfarin. Ask your prescriber for additional information. Always seek medical advice from your healthcare provider before discontinuing Eliquis or switching to a new medication.

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