Eliquis is popular blood thinning medication that is often used to reduce the risk of strokes or deal with blood clotting issues. Because it is a brand-name medication, the list price of Eliquis is usually extremely high. However, few people end up paying this full amount. Nevertheless, it can be complex to find out how much you can actually expect to pay for this medication when you have Medicare.

We’ll run through all of the details you need to know about Eliquis. This includes what it is, why it’s so expensive, how it’s covered by Medicare and some ways you may be able to get it for a lower price.

What is Eliquis?

Eliquis is an anticoagulant medication developed by Pfizer. This can be used to treat a variety of conditions, including strokes, deep vein thrombosis, atrial fibrillation (AFib)/irregular heartbeat, pulmonary embolism, and blood clots. Eliquis prescriptions can last for varying amounts of time depending on your condition.

Eliquis is the brand name of a medication developed by Pfizer. The name of the drug itself is Apixaban. Because this drug is offered under a brand name, the price can be very high for some. Although there is a generic version that is newly available (to be discussed later on), name-brand Eliquis is still more common for now.

This information is no substitute for medical advice from your healthcare provider. Make sure you seek further information about side effects and other details thoroughly before you take any steps.

What about generic Eliquis?

The generic form of Eliquis, known as Apaxiban, was only approved by the FDA in late 2019. For this reason, it can still be more difficult to find than brand-name Eliquis. However, the drugs will function in effectively the same way, and generic Apaxiban will almost certainly be cheaper for most.

This is made more complex by the fact that there are more discount options available for name-brand Eliquis. Generic Apaxiban is still likely to be cheaper when available, but name-brand Eliquis can end up being quite affordable with a discount and proper coverage.

How much does Eliquis cost?

As we mentioned, the cost of Eliquis is extremely high for most, coming in at over $500 for a 30 day supply. However, most people do not end up paying this amount. If you see this as the listed price, it is no error, but you can expect to pay significantly less for a few reasons.

If you have prescription drug coverage, then your plan will likely cover the majority of the cost of Eliquis once you’ve met your deductible. If you don’t have a prescription drug plan, there are a variety of savings options available that can drastically reduce the cost of Eliquis.

Find a Medicare plan that covers Eliquis

It’s important to note, however, that this list price of Eliquis may still be paid in full by some who don’t have these options available. Because Eliquis is such an expensive medication, you should make sure that you have a coverage plan available that can take care of as much of the costs as possible.

Medicare coverage of Eliquis

If you have Medicare and need an Eliquis prescription, there are a few options available to you. Original Medicare (Medicare Part A and Part B) doesn’t cover self-administered prescription drugs. This includes Eliquis. There are no real exceptions here; Original Medicare simply does not cover prescription drugs.

However, there are a variety of other options available for Medicare beneficiaries. These will vary in cost and coverage type, but let’s take a look at them one by one. Remember, although the options discussed are part of Medicare, they are not part of Original Medicare. If you only have Original Medicare, you will need additional coverage to get Eliquis covered.

Medicare Part D plans and Eliquis coverage

Medicare Part D prescription drug plans are a popular way to get additional prescription drug coverage that isn’t available from Original Medicare. Prescription drug plans are offered by private insurance companies but are only available to Medicare beneficiaries. They are regulated by the government to some degree, but the prices and coverage will still vary as they do under most private plans.

Part D has a maximum deductible amount of $545, so no plan will be able to include a higher deductible in 2024. This means that even if you have Part D coverage for Eliquis, you will still need to pay these costs before your coverage begins.

Premiums for Part D average around $40-45 per month, although there is a large amount of variety here, and some people will pay significantly more (or less) than this. There is also a Part D income-related monthly adjustment which will require you to pay additional fees to the United States government, depending on your income.

The actual cost of Eliquis under Part D will also vary widely. However, some people pay under $50 per month for their Eliquis coverage, which is obviously much lower than the list price. If your plan covers Eliquis , then you will pay much lower than the list price, but check your plan's details and compare plans to see how these costs apply to you. Your Part D plan may also require you to obtain prior authorization before it approves a name-brand prescription when generic alternatives are available.

Eliquis and Medicare Advantage

Although Medicare Advantage, also known as Part C, primarily serves as a person's main health insurance and as a substitute for Original Medicare, some plans also include prescription drug coverage. If you have a Medicare Advantage plan and it includes drug coverage, then you won’t be able to add an additional drug plan to your coverage. For this reason, it’s important to make sure that your Part C plan provides you with the coverage that you need.

The costs for Part C prescription drug coverage will be roughly the same as Part D. And, again, it’s important to remember that they can vary widely depending on where you’re located and other life details. If you have a Part C drug plan, Eliquis will likely appear somewhere on the plan formulary or drug list, but you should make sure that the costs are appropriate for what you’re able to pay if you know you need Eliquis before you choose your plan.

Can Medigap plans help me save money?

Medigap plans, also known as Medicare Supplement plans, help pay for your out-of-pocket costs under Medicare. This includes costs like your Part A coinsurance and copay, your Part A deductible, and so on.

While Medigap plans can be very helpful when dealing with Original Medicare costs, they do not apply in any way to Part D plans, as Original Medicare doesn't cover prescription medications - and Medigap plans only cover services included with your Medicare coverage. If you have Medicare Advantage, you cannot have a Medigap plan.

Although Medigap plans are helpful, they cannot help lower the cost of your Eliquis prescription.

Other cost-saving tools

There are additional measures that you can use to help lower the cost of Eliquis. These will not apply to everyone, but you should look into them if you think you will qualify.

You may be able to get an Eliquis coupon card that can be used to lower your copayment for each 30 day supply, for up to 24 months. You can also use a 30-day Eliquis trial card, which gives you a 30 day supply for free, no matter what your insurance details are. You’ll have to visit eliquis.com to get contact information and further details about these discount options.

Eliquis and Medicare coverage: What to remember

The key thing to remember is that you need prescription drug coverage. Original Medicare alone will not cover Eliquis, period. Whether this takes the form of a Part D plan or Medicare Advantage is up to you, but make sure you have a plan.

Our Find a Plan tool makes it easy to review your Medicare plan options. Just enter your zip code to get started.

You should always seek additional information from your doctor about any prescription drugs or treatment plans you have any intention to go forward with.

Additional resources

• ClearMatch Medicare: Find a Medicare Plan
• Medicare.gov: Extra Help