Does Medicare cover Eliquis?
Atrial fibrillation, or AFib, happens when a person has an irregular heartbeat. There are various treatment options for AFib like taking medications and cardiac ablation. One medication that doctors often prescribe for AFib is a blood thinner called Eliquis. Eliquis is the brand name for apixaban.
Medicare Part D (prescription drug coverage) helps cover most AFib medications, including Eliquis. We’ll explain how Eliquis works, how Medicare Part D works, and what other blood thinners you may find on your plan’s list of covered drugs.
Key takeaways:
Medicare Part D helps cover Eliquis, a blood thinner doctors often prescribe for treating AFib.
Your prescription drug plan should cover most medications for AFib, but it’s a good idea to check your plan’s drug list (also called a formulary) to make sure Eliquis is on it.
What is Eliquis?
Eliquis is an anticoagulant, or blood thinner, that people use to manage AFib, a condition that occurs when your heart beats abnormally. When your heart beats irregularly, it affects your heart’s ability to pump blood, which can lead to symptoms like:
Dizziness
Shortness of breath
Heart palpitations
Fatigue
People with AFib have an increased risk of stroke, heart failure, and other heart-related complications. Eliquis helps to reduce these risks by preventing blood clots.
Does Medicare cover Eliquis?
Without insurance, Eliquis can cost almost $500 for a month’s supply! Fortunately, most Medicare prescription drug plans help cover Eliquis. Generally, most AFib medications are covered by Medicare because they’re common prescriptions among older adults. Though highly unlikely, in the event that your plan doesn’t cover Eliquis (or another drug you need), you have a few options:
Talk to your doctor and see if there’s a similar blood thinner that your plan covers for AFib treatment.
Request a formulary exception. This is a formal request to add a drug to your plan’s list. Your healthcare provider has to approve a formulary exception.
Switch plans during the Annual Enrollment Period. You can choose a drug plan that better fits your needs during this enrollment period. If you need help picking the best one for you, our team of dedicated Advisors would be happy to guide you through your options with free, personalized advice. Call today at 855-900-2427 or schedule an appointment to talk.
It’s always a good idea to familiarize yourself with your plan’s formulary once you choose and enroll in a Medicare Part D plan.
Though all Part D plans vary in pricing and coverage, you can generally expect to pay between $2 and $18 for a 30-day supply of the drug.
Medicare Part D
Medicare Part D is an optional, but recommended, prescription drug plan beneficiaries can purchase. You can get Part D coverage through either a Medicare Advantage plan that includes it or with a standalone Part D plan.
Each Part D plan has a formulary, which is a list of covered drugs. The formulary categorizes drugs into tiers, which help determine your copay for different prescriptions.
If you have AFib, make sure that you choose a plan that covers prescriptions for Eliquis or other relevant blood thinners. The good news is that it should be easy to find one that does!
What other blood thinners are covered by Medicare?
Most Medicare prescription drug plans cover another common blood thinner called Xarelto. Like Eliquis, healthcare providers consider Xarelto a preferred medication to treat AFib. It works similarly to Eliquis by preventing blood clots from forming.
Consult with your healthcare provider about what medications are best for you to manage AFib. Everyone’s healthcare needs are unique, and choosing between Eliquis and Xarelto will depend on your individual AFib requirements.
If you have any questions about Medicare or need help determining if your prescription is covered by your Medicare plan, we’re here to help! Call today at 855-900-2427 or schedule an appointment to get help understanding and using your Medicare coverage.