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Drug Info

What tier drug is Eliquis?

Although drug formularies vary by plan, many place Eliquis on Tier 2
Rosemary Black
By | Feb. 11, 2025 Medically reviewed by Leslie Greenberg, MD
A health insurance card and three pills: What tier drug is Eliquis?

Key takeaways

  • Eliquis is a prescription blood thinner medicine that is prescribed to reduce the risk of stroke and systemic embolism in some patients.

  • The cost of Eliquis depends on which Tier the medication is on. This varies by insurance policy. However, many insurance plans place Eliquis on Tier 2, which is the second most affordable tier. 

  • SingleCare coupons can help you save on Eliquis if your health insurance company places it on a higher tier. 

  • Eliquis alternatives such as Pradaxa, Xarelto, and Savaysa may be on lower, more affordable tiers, depending on your policy. 

In this article:

Eliquis (apixaban) is a prescription blood thinner medication that is prescribed to reduce the risk of stroke and blood clots in people with a condition called atrial fibrillation (AFib) that is not caused by a heart valve problem. Eliquis is also prescribed to treat blood clots in the legs, known as deep vein thrombosis (DVT), and blood clots in the lungs, known as pulmonary embolism (PE). If your healthcare provider prescribes Eliquis, you may wonder which medical insurance tier it is on and how much you’ll be expected to pay. But there’s more to it than just the tier. We’ll break down drug tiers and how insurance formularies treat Eliquis. 

Understanding your drug formulary

A formulary is a list of drugs that are covered by your insurance company, whether it’s commercial health insurance, Medicare, or Medicaid. Drugs are placed in tiers, and the higher the tier, the more expensive the drug is for the patient. Some drug formularies may have only three tiers, while others may have up to five. Tier 1 drugs are typically generic and have the lowest copay that the patient is expected to pay. The middle tiers may include a mix of generics, preferred brands, and nonpreferred brands. The highest tier typically includes nonpreferred, brand, and specialty drugs. The highest tier will have the highest out-of-pocket cost for the patient. 

What drug tier is Eliquis on?

Eliquis is on Tier 2 of many prescription drug plans, but some insurances place it on Tier 1 or Tier 3. For any drug, the tier it is placed on may vary from one insurance company to the next, and even between plans from the same company. Insurances change which tier medication is on at different times, so the cost from the pharmacy can change throughout the calendar year. This United HealthCare Medicare plan places Eliquis in Tier 3. In contrast, this Anthem Blue Cross Blue Shield preferred drug list has Eliquis listed as a Tier 2 drug. 

Since insurance coverage varies widely, it may help instead to get an idea of what you can expect to pay for Eliquis. According to Bristol-Myers Squibb Company, the drug’s manufacturer, most people pay the following:

  • Patients with commercial health insurance (private or employer-sponsored): $38 per month, although half pay $20 or less
  • Medicaid: $2 per month, although half pay $0
  • Medicare beneficiaries: $55 per month, although half pay $40 or less
  • Medicare Low-Income Subsidy (Medicare Extra Help) beneficiaries: $0 to $11.20 per month  

If Eliquis is not a covered medication on your formulary, you may contact your insurance company to ask for a list of similar drugs that are covered by your plan and thereby have a less expensive out-of-pocket cost for you. Your healthcare provider may also request an exception or fill out a prior authorization form, which may convince your insurance company to provide coverage for a drug normally not provided by your plan. 

How much does Eliquis cost?

Without insurance, the average retail price of 60, 5 mg tablets of Eliquis, which is typically a month’s supply, is $787. There are ways to save, however. For example, a SingleCare coupon for Eliquis can lower the price to $479, depending on your location and pharmacy. 

Eliquis alternatives

If Eliquis is too expensive, talk to your healthcare provider. They may be able to recommend alternatives that are more affordable and still considered effective. “The choice of medicine depends on individual health factors, so it’s important to consult your doctor,” explains Alyssa Wozniak, Pharm.D., BCPS, assistant dean for clinical affairs, outreach, and special projects in the School of Pharmacy at D’Youville University. 

Although the FDA approved a generic version of Eliquis in 2019, it is not expected to be available until 2028. “The generic version is not available due to ongoing patent protections,” Wozniak says. Once available, the generic version will likely cost less, and Eliquis will become a less expensive treatment option.

Although Eliquis doesn’t have a generic version, there are other blood thinner medications that may be effective and considered Eliquis alternatives. Examples include Pradaxa (dabigatran), Xarelto (rivaroxaban), and Jantoven (warfarin). Warfarin is an older anticoagulant, and since it is a generic and often Tier 1 drug, it may be a more affordable option. “However, warfarin requires frequent blood monitoring and dietary restrictions,” Wozniak says.

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