How Much Does Eliquis Cost with Medicare?
Eliquis has a retail price of $561, but thankfully, there are a variety of Medicare plan options in Decatur, IL that can get that price down to less than $50 per month.
However, the costs of Eliquis with Medicare depend on your plan and which pharmacy you go to. In this article, we’ll help you understand why Eliquis is so expensive and what you can do about it.
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What Is Eliquis?
Eliquis (also known as apixaban) is a prescription medication used to reduce the risk of stroke and blood clots in people with certain medical conditions. It belongs to a class of drugs called anticoagulants, or blood thinners, which work by preventing the formation of blood clots in the body.
Eliquis is commonly used to treat conditions such as atrial fibrillation, deep vein thrombosis, and pulmonary embolism.
It’s taken orally in tablet form, and the dosage and duration of treatment depend on the individual's medical condition and other factors.
How Much Does Eliquis Cost?
The cost of Eliquis varies depending on the pharmacy, insurance coverage, and treatment plan. According to GoodRx, the lowest price for Eliquis in Decatur, IL is $546.53 at Meijer Pharmacy, which gets you a supply of 60 tablets.
According to the Eliquis website, the list price for a 30-day supply of Eliquis is $561, though there are some money-saving options that could get your costs down.
That said, if you’re on Medicare, you won’t qualify for the money-saving options marketed on the Eliquis website, such as a co-pay card that allows you to pay as little as $10 per month for up to 2 years.
Why Is Eliquis So Expensive?
Eliquis is one of the most expensive blood thinners in the United States.
The high cost of Eliquis is partly due to the fact that the U.S. government doesn’t impose any restrictions on the markup pharmaceutical companies can add to the production cost of a drug.
Eliquis is also a brand name drug, which is protected under a patent for 20 years. That patent should have expired in February 2023. But due to a patent dispute, it has been extended to November 2026.
Even though the FDA has approved the first generic versions of Eliquis (apixaban), it looks like these may not be available to the general public until 2026.
Does Medicare Cover Eliquis?
Medicare helps cover the costs of Eliquis (apixaban) under Part D prescription drug coverage or through a Medicare Advantage plan that comes with prescription drug coverage.
However, the amount of coverage and out-of-pocket expenses will depend on the specific plan you have. And unfortunately, you won’t save money by using GoodRx instead of your drug plan.
Medicare Part D and Eliquis
Medicare Part D plans have a formulary, or list of covered drugs, which varies from plan to plan.
When we run a drug plan comparison for you, we’ll enter the drugs you take, including Eliquis, and the system will show us which plans are the most cost effective. They’re even listed in order, making it easy to quickly see how much each plan would cost you on an annual basis.
You will save some money by getting your Eliquis prescription through a preferred, in-network pharmacy, so make sure you know which pharmacy to go to.
One of the most competitive 2023 Part D drug plans covers Eliquis at a $44 copay.
Because Part D plans have a $505 deductible, your first month would cost $549, and subsequent months would cost $44. You may reach the donut hole, and in that case, your agent can explain how your copays at the pharmacy may fluctuate toward the end of the year.
Medicare Advantage and Eliquis
You may decide to choose a Medicare Advantage plan, which is an all-in-one alternative to Original Medicare.
Some Medicare Advantage (MA) plans are a bit more favorable towards Eliquis than Part D drug plans.
Many MA plans do not have a drug deductible, so you don’t need to shell out over $500 for your first pharmacy copay. Instead, you only need to pay your copay, which varies, but many plans are in the $37-$47 range.
That said, you will need to compare your entire health plan when deciding between Medicare Advantage and Original Medicare paired with a supplement and Part D drug plan.
While the MA plan may save you a $500 drug deductible, it may pose more than a $500 financial risk if you were to find yourself in a hospital, as an example.
Our licensed agents can help you tease out those differences so you can make an informed decision.
The retail price of Eliquis is $561, but fortunately, there are several Medicare plans available that can reduce the cost to less than $50 per month.
By 2026, we should be seeing generic versions of Eliquis hit the market, and we won’t have to worry about this financial burden any longer!
If you take Eliquis or know someone who does, don’t hesitate to reach out to our office for a no-cost, no-obligation plan comparison. We are passionate about educating and assisting our community with all things Medicare and retirement.
Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
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