Does Affinity Health Plan Cover Eliquis

Explore if Affinity Health Plan covers Eliquis and learn how to secure coverage, costs without insurance, and FAQs in this detailed guide.
Curex allergy drops unboxing
“Curex is changing the landscape of allergies in 2024”
man opening Curex packaging
man opening Curex packaging

 

Coverage Overview

 

  • Affinity Health Plan may cover Eliquis, a prescription anticoagulant, under its prescription drug plan. Coverage can depend on the plan tier and formulary status.
  •  

  • To confirm coverage, members should refer to their plan's formulary list or consult their benefits administrator.

 

Covered Situations

 

  • Eliquis is typically covered for conditions such as atrial fibrillation (non-valvular) to reduce the risk of stroke and systemic embolism, and for the treatment and prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE).
  •  

  • Some plans may require prior authorization to determine medical necessity before Eliquis is covered.

 

Basic Criteria for Coverage

 

  • Coverage usually requires a prescription from a healthcare provider following a diagnosis that matches the plan's criteria for medical necessity.
  •  

  • Members might need to use in-network pharmacies to access covered benefits.
  •  

  • Cost-sharing aspects like co-pays, deductibles, or coinsurance may apply based on the specific Affinity Health Plan.

 

Want to try immunotherapy?

Start with Curex

Covered

Uncovered

Treat your allergies with Curex - $49  $9.99

Review your allergy test results with a Curex allergist.

Our team is here to help!

Dr. Neeta Ogden, MD

Curex is poised to revolutionize the way allergies are treated in America, expanding access to clinical care and treatments that can meaningfully improve patients quality of life.

Dr. Ravi Patel, VP Telemedicine

At Curex, our mission is to help people improve their health and quality of life by understanding their allergies and treating them at their source.We provide more than individualized prescription treatments; we provide individualized care.

Jill Hamburg, PA - C

Immunotherapy made simple.  We enable patients to receive personalized allergy care on their own time. No more waiting rooms.

Dr. Chet Tharpe, Medical Director

Curex has set the standard for the virtual allergy experience. From the comfort of their home, patients nationwide are able to receive a personalized treatment plan from an experienced clinician, aimed at treating the source of their allergies, not just the symptoms.

Kayla Mardaga, NP

Curex offers convenient at-home allergy testing options. Our goal is to determine if a patient would benefit from immunotherapy and then customize a treatment plan that can reduce both the symptoms and the reliance on allergy medications.

How to Get Eliquis Coverage with Affinity Health Plan

 

Initiate Your Affinity Health Plan Coverage

 

  • Visit the Affinity Health Plan website to become familiar with the options they offer.
  •  

  • Contact Affinity Health Plan’s customer service or use their online portal to gather detailed information about their prescription drug coverage and formularies.
  •  

 

Verify Prescription Drug Coverage

 

  • Find out if Eliquis is covered by reviewing the list of covered medications (formulary) under your specific Affinity Health Plan.
  •  

  • Ensure you understand the terms of coverage, including any copays, coinsurance, or limits applicable to Eliquis.
  •  

  • Contact Affinity’s customer service if you have any questions regarding Eliquis coverage specifics.
  •  

 

Consult With Your Healthcare Provider

 

  • Discuss with your healthcare provider the necessity of Eliquis for your treatment and confirm if alternatives are available if Eliquis is not covered.
  •  

  • Request a prescription for Eliquis from your healthcare provider if it is covered under your plan.
  •  

 

Submit Prior Authorization if Required

 

  • If Eliquis requires prior authorization, have your healthcare provider assist in submitting the necessary documentation to Affinity Health Plan.
  •  

  • Ensure all medical justifications and supporting documents are included to enhance approval chances.
  •  

 

Follow Up on Approval Status

 

  • Regularly check with Affinity Health Plan regarding the status of your prior authorization submission, if applicable.
  •  

  • Once approved, confirm that your prescription for Eliquis is ready for pick-up at a preferred pharmacy within Affinity's network.
  •  

 

Review Your Pharmacy Benefits

 

  • Identify in-network pharmacies where you can fill your Eliquis prescription under Affinity Health Plan to minimize out-of-pocket expenses.
  •  

  • Verify any mail-order pharmacy options offered by Affinity Health Plan that might provide extended supplies of medications at reduced costs.
  •  

 

Utilize Additional Resources

 

  • Explore any appeals process Affinity Health Plan offers if initial coverage decisions are unfavorable, and Eliquis remains a necessity.
  •  

  • Investigate additional support programs or savings plans that might assist with Eliquis costs, even outside your insurance coverage.
  •  

 

Curex allergy drops unboxing

We love helping people!

Allie, Nevada

five stars

"I have two cats I can finally cuddle!"

Cat and dog allergies

Zachary, Texas

five stars

“I can breathe through my nose for the first time in like 20 years!"

dust allergy
mold allergy

Dust and mold allergies

Erika, New York

five stars

“I've noticed less sneezing and shortness of breath.”

tree allergy
grass allergy

Tree and grass allergies

Richard, Texas

five stars


I love the convenience!

tree allergy

Tree and cat allergies

We Treat Food, Indoor & Outdoor Allergies

tree allergy
Tree Pollens
maple leaf icon
Weed Pollens
Cat Allergies
Dog Allergies
insect icon
Dust Mites
mold allergy
Molds
Food Allergies
 curex user showing allergy treatment kita patient showing allergy treatment boxa male patient showing allergy drops vial
50,000+ users have overcome their allergies
Am I eligible?

Benefits of Curex

At-home treatment

Apply treatments in minutes from the comfort of your own home with under-the-tongue applications instead of shots or pills

5-30x higher cumulative dose vs allergy shots

Sublingual immunotherapy delivers a higher dose of allergens over the course of treatment.

Potential for results in as few as 6 months

Individual results vary but some users have reported a noticeable difference in as few as 6-12 months since starting treatments

Excellent safety profile

Studies that have been reviewed by certified physicians show that sublingual immunotherapy is a safe treatment option
male medical practitioner smiling

Treatment prescribed
by clinician

1
right line icon
Curex packaging

Clinicaly made allergen extracts are customized for your allergies

2
right line icon
insect icon
grass icon
man opening Curex packaging

Your immune system gets desensitized to allergens, giving you long-term relief.

3

FAQs

Does Affinity Health Plan Cover Eliquis

Explore if Affinity Health Plan covers Eliquis and learn how to secure coverage, costs without insurance, and FAQs in this detailed guide.
Curex allergy drops unboxing

Is Eliquis Covered by Affinity Health Plan

 

Coverage Overview

 

  • Affinity Health Plan may cover Eliquis, a prescription anticoagulant, under its prescription drug plan. Coverage can depend on the plan tier and formulary status.
  •  

  • To confirm coverage, members should refer to their plan's formulary list or consult their benefits administrator.

 

Covered Situations

 

  • Eliquis is typically covered for conditions such as atrial fibrillation (non-valvular) to reduce the risk of stroke and systemic embolism, and for the treatment and prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE).
  •  

  • Some plans may require prior authorization to determine medical necessity before Eliquis is covered.

 

Basic Criteria for Coverage

 

  • Coverage usually requires a prescription from a healthcare provider following a diagnosis that matches the plan's criteria for medical necessity.
  •  

  • Members might need to use in-network pharmacies to access covered benefits.
  •  

  • Cost-sharing aspects like co-pays, deductibles, or coinsurance may apply based on the specific Affinity Health Plan.

 

A weight management program tailored to you

Start with Curex

Affinity Health Plan's Approved Criteria for Eliquis Coverage

 

Eliquis Coverage Criteria

 

  • Affinity Health Plan provides coverage for Eliquis for patients who have been diagnosed with conditions such as non-valvular atrial fibrillation, deep vein thrombosis, or pulmonary embolism.
  •  

  • Coverage is also approved for patients who require Eliquis for the reduction of risk of recurrent deep vein thrombosis and pulmonary embolism following initial therapy.
  •  

  • Patients who are scheduled for hip or knee replacement surgery and require Eliquis for the prophylaxis of deep vein thrombosis to reduce the risk of pulmonary embolism are covered.
  •  

 

Required Documentation for Coverage

 

  • Clinical documentation must be provided indicating the diagnosis of the condition for which Eliquis is being prescribed.
  •  

  • For patients with non-valvular atrial fibrillation, records should include an assessment of the patient's risk of stroke.
  •  

  • If treating venous thromboembolism, records need to show the plan for use and duration.
  •  

  • Physician's prescription detailing the dosing regimen of Eliquis specific to the patient's condition must be included.
  •  

 

Clinical Guidelines

 

  • Patients must have a documented contraindication or demonstrated intolerance to warfarin or other anticoagulants, unless Eliquis is being used for post-surgical prophylaxis.
  •  

  • For patients with atrial fibrillation, they should have a CHA2DS2-VASc score that indicates the need for anticoagulation (as per standard clinical practice guidelines).
  •  

  • Requests for Eliquis must adhere to the dosing guidelines as approved by relevant medical authorities and specified in the prescribing information.
  •  

 

Renewal and Re-Evaluation

 

  • Coverage renewal requests must include updated clinical documentation demonstrating the continued need for Eliquis therapy.
  •  

  • Patients should undergo regular follow-ups as specified by their healthcare provider to assess the efficacy and safety of Eliquis treatment.
  •  

  • Dose adjustments, if necessary, should be documented with rationale based on clinical evaluation.
  •  

 

Why Affinity Health Plan Might Deny Eliquis Coverage

 

Reasons for Denial of Eliquis Coverage by Affinity Health Plan

 

  • **Non-Formulary Status**: Affinity Health Plan may deny Eliquis coverage if it is not listed on their approved drug formulary, meaning it is not a preferred medication within their plan.
  •  

  • **Lack of Medical Necessity**: Coverage for Eliquis may be denied if there is insufficient documentation or evidence provided to demonstrate the medical necessity for prescribing it. The health provider must clearly establish that Eliquis is critical to the patient's health condition.
  •  

  • **Prior Authorization Requirement**: If Eliquis requires prior authorization and the necessary approval has not been obtained from Affinity Health Plan before the prescription is filled, they may deny coverage.
  •  

  • **Step Therapy Protocols**: Affinity Health Plan might require patients to try and fail more cost-effective alternatives before approving Eliquis. If these steps are not followed, coverage could be denied.
  •  

  • **Excluded Conditions**: Specific conditions not covered under the plan may result in denial if Eliquis is prescribed for such uses. Ensure the condition being treated is on the list of covered indications.
  •  

  • **Quantity Limits**: Exceeding established quantity limits without appropriate justification or approval may lead to denial. Ensure prescriptions align with recognized dosing guidelines.
  •  

 

Together with our partners we have changed the lives of over 300,000 patients.

How Much Does Eliquis Cost without Insurance?

 

Approximate Cost of Eliquis without Insurance

 

  • The cost of Eliquis, a commonly prescribed blood thinner, can vary based on the pharmacy, location, and any available discounts or coupons. On average, without insurance, Eliquis can cost around $550 to $650 for a 30-day supply.
  •  

  • Some pharmacies or online platforms may offer discounts or generic options that can lower the cost, so it's advisable to shop around. Patients should also inquire about manufacturer coupons or assistance programs that might help reduce the price.
  •  

  • Price comparison tools and websites can be helpful in finding the best available prices for Eliquis in your area.

 

Our team is here to help!

Dr. Neeta Ogden, MD

Curex is poised to revolutionize the way allergies are treated in America, expanding access to clinical care and treatments that can meaningfully improve patients quality of life.

Dr. Ravi Patel, VP Telemedicine

At Curex, our mission is to help people improve their health and quality of life by understanding their allergies and treating them at their source.We provide more than individualized prescription treatments; we provide individualized care.

Jill Hamburg, PA - C

Immunotherapy made simple.  We enable patients to receive personalized allergy care on their own time. No more waiting rooms.

Dr. Chet Tharpe, Medical Director

Curex has set the standard for the virtual allergy experience. From the comfort of their home, patients nationwide are able to receive a personalized treatment plan from an experienced clinician, aimed at treating the source of their allergies, not just the symptoms.

Kayla Mardaga, NP

Curex offers convenient at-home allergy testing options. Our goal is to determine if a patient would benefit from immunotherapy and then customize a treatment plan that can reduce both the symptoms and the reliance on allergy medications.

How to Get Eliquis Coverage with Affinity Health Plan

 

Initiate Your Affinity Health Plan Coverage

 

  • Visit the Affinity Health Plan website to become familiar with the options they offer.
  •  

  • Contact Affinity Health Plan’s customer service or use their online portal to gather detailed information about their prescription drug coverage and formularies.
  •  

 

Verify Prescription Drug Coverage

 

  • Find out if Eliquis is covered by reviewing the list of covered medications (formulary) under your specific Affinity Health Plan.
  •  

  • Ensure you understand the terms of coverage, including any copays, coinsurance, or limits applicable to Eliquis.
  •  

  • Contact Affinity’s customer service if you have any questions regarding Eliquis coverage specifics.
  •  

 

Consult With Your Healthcare Provider

 

  • Discuss with your healthcare provider the necessity of Eliquis for your treatment and confirm if alternatives are available if Eliquis is not covered.
  •  

  • Request a prescription for Eliquis from your healthcare provider if it is covered under your plan.
  •  

 

Submit Prior Authorization if Required

 

  • If Eliquis requires prior authorization, have your healthcare provider assist in submitting the necessary documentation to Affinity Health Plan.
  •  

  • Ensure all medical justifications and supporting documents are included to enhance approval chances.
  •  

 

Follow Up on Approval Status

 

  • Regularly check with Affinity Health Plan regarding the status of your prior authorization submission, if applicable.
  •  

  • Once approved, confirm that your prescription for Eliquis is ready for pick-up at a preferred pharmacy within Affinity's network.
  •  

 

Review Your Pharmacy Benefits

 

  • Identify in-network pharmacies where you can fill your Eliquis prescription under Affinity Health Plan to minimize out-of-pocket expenses.
  •  

  • Verify any mail-order pharmacy options offered by Affinity Health Plan that might provide extended supplies of medications at reduced costs.
  •  

 

Utilize Additional Resources

 

  • Explore any appeals process Affinity Health Plan offers if initial coverage decisions are unfavorable, and Eliquis remains a necessity.
  •  

  • Investigate additional support programs or savings plans that might assist with Eliquis costs, even outside your insurance coverage.
  •  

 

Premium Medication you can trust

Our weight loss medication is delivered straight to your doorstep from a state-licensed pharmacy within our reliable network, ensuring you receive your medication when you need it.

Each pharmacy in our network undergoes rigorous third-party testing through FDA and DEA certified labs. These tests focus on four key elements, ensuring both safety and efficacy for our treatments.

Eliquis FAQ

What are the side effects of Eliquis?

 

Common Side Effects of Eliquis

 

  • Mild bleeding or bruising due to its anticoagulant effect.
  • Nausea, which may occur as your body adjusts to the medication.
  • Skin rash or minor allergic reactions.
  • Fatigue or general weakness.

 

Serious Side Effects

 

  • Severe bleeding, including unusual bleeding from gums, nosebleeds, or heavier than usual menstrual bleeding.
  • Red, pink, or brown urine and black or bloody stools indicating internal bleeding.
  • Severe headache, dizziness, or fainting, which could indicate a bleed in the brain.
  • Signs of anemia, such as pale skin, weakness, or fatigue.

 

Consult Your Doctor

 

  • Always report any unusual symptoms to your healthcare provider promptly.
  • Seek emergency medical attention for significant bleeding or symptoms of a serious allergic reaction like difficulty breathing.

 

Is Eliquis a blood thinner?

 

Is Eliquis a Blood Thinner?

 

  • Yes, Eliquis (apixaban) is a blood thinner, also known as an anticoagulant.
  •  

  • It prevents blood clots by inhibiting Factor Xa, which is crucial in the clotting process.
  •  

  • Doctors prescribe Eliquis to reduce stroke risk in patients with atrial fibrillation and to treat or prevent deep vein thrombosis (DVT) and pulmonary embolism (PE).
  •  

  • Ensure regular monitoring and follow-ups with your healthcare provider while on Eliquis for safe management.
  •  

  • Contact a healthcare professional if you have concerns about bleeding risks or interactions with other medications.

 

Can you take Eliquis with alcohol?

 

Alcohol and Eliquis Interaction

 

  • Moderate alcohol consumption might be safe, but heavy drinking can increase bleeding risk.
  •  

  • Consult your healthcare provider to assess your specific condition and alcohol tolerance.

 

Potential Effects of Combining

 

  • Both Eliquis and alcohol affect blood clotting, raising potential for heightened bleeding.
  •  

  • Alcohol can augment Eliquis' effects, complicating the management of conditions like atrial fibrillation.

 

Recommendations for Use

 

  • If you drink, limit to one or two standard drinks occasionally and monitor for bruising or bleeding.
  •  

  • Report any unusual symptoms to your healthcare provider immediately.

 

Have questions left?

Get a personalized online consultation with a doctor at Curex

Curex is one of America’s largest telehealth providers

Together with our partners we have changed the lives of over 300,000 patients. Here’s what some of them have to say:

“Curex has performed beyond my expectations. I am feeling tremendously better and look forward to continuing the treatment.”
Becky D.
"If I could give 6 stars, I would. BEST... BEST… BEST… service.”
Ferdian K.
“The Curex staff has been professional, efficient, and really focused on my individual needs.”
Ana C.

Start your
journey now

Everything you need is included:

Online consultation

Your prescription

Premium medication

Overnight shipping

Ongoing support

A weight management program tailored to you

Initial Dosage

Your initial medication and dosage are carefully determined by doctors, taking into account your unique health profile. This ensures a personalized and safe treatment plan tailored to your specific needs.

Titration

We gradually adjust your dosage to reach the optimal therapeutic level, ensuring maximum effectiveness while minimizing potential side effects.

Additional Treatments

Our providers may also recommend medications such as metformin or supplements such as vitamin B12. We recognize the importance of managing side effects, so your care plan may include medication to alleviate them.

Got questions? We have answers.

Do your plans include prescriptions and medications?

Curex plans cover everything from reviewing your medical intake to providing prescription medications, with free shipping included. There are no extra or hidden charges. Prescriptions are issued only after a medical provider reviews your information to confirm that the medication is suitable for you. Our service includes continuous support and regular follow-ups to ensure your treatment stays on track.

Our clinicians may order labs and additional medications for you, which would not be covered by the plan but for which you can use your insurance.

Please note: Compounded medications are tailored to individual needs or used in case of shortages, but they are not FDA-approved for safety or effectiveness. A prescription is required. Results may vary from person to person.

What medications do your providers prescribe?

We prioritize a personalized approach to your health. If your medical provider prescribes medication, options may include GLP-1 treatments such as compounded semaglutide (the active ingredient in Wegovy®* and Ozempic®*). Our providers prescribe only combination treatments not available at your local pharmacy that may include vitamin B12, etc. to help you achieve your goals faster.

Depending on your treatment goals, other medications such as metformin may also be considered. We recognize the importance of managing side effects, so your care plan might include medication to ease symptoms like nausea. Your well-being is always our top priority!

Please note that compounded medications are customized to meet individual patient needs and are not FDA-approved for safety or effectiveness. A prescription is necessary. Results may vary from person to person.

Curex and its pharmacy partners do not have any association with Novo Nordisk.

Will I be prescribed semaglutide if I sign up?

Your health journey is unique, and we tailor our care to match. Any prescriptions, including semaglutide, will be based on the expert assessment of the medical provider matched with you through our platform. You can trust that your treatment plan will be personalized to fit your specific needs. And if semaglutide is not prescribed, we will provide a full refund.

What is compounded medication?

Compounding involves creating customized medications to meet the specific needs of individual patients. For instance, a patient may require a liquid version of a medication that is only available in tablet form. Pharmacies can also compound medications using FDA-approved drugs that are on the FDA’s shortage list.

These compounded medications are made by state-licensed pharmacies that follow both federal and state regulations, including quality standards. However, when compounded in accordance with these laws, these medications are not subject to FDA approval and are not evaluated for safety or effectiveness.

Is compounded medication the same as generic medication?

Compounded medications differ from generic drugs. Generics require FDA approval by demonstrating bio-equivalence to the brand-name drug. In contrast, compounded medications are not FDA-approved. They are made based on a personalized prescription that may not be commercially available elsewhere or when a drug appears on the FDA’s shortage list. Compounding pharmacies must have the proper licensed facilities and comply with state and federal regulations before dispensing these medications.

Is insurance required?

No, Curex doesn’t require insurance. We offer clear and simple pricing, along with affordable medication options, making it easy and accessible to take care of your health.

Can I pay with an FSA or HSA card?

Yes! You can pay with your HSA or FSA card.

How much does treatment cost?

Semaglutide Injections:

Prices for semaglutide start at only $149 per month for weekly doses of 0.25mg and 0.5mg. You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 1mg, 1.7mg and 2.4mg of semaglutide for an additional $50 per month for each plan.

Tirzepatide Injections:

Prices for tirzepatide start at only $249 per month for weekly doses of 2.5mg and 5mg of tirzepatide.You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 7.5mg, 10mg and 12.5mg of tirzepatide for an additional $100 per month for each plan.

Semaglutide Tablets:

Prices for semaglutide tablets start at only $149 per month for daily doses of 2mg. You can cancel anytime. Some people experience weight loss at this dose and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 4mg and 8mg of semaglutide daily for an additional $50 per month for each plan.

Tirzepatide Tablets:

Prices for tirzepatide start at only $199 per month for daily dosees of 3mg of tirzepatide. You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 6mg and 12 mg of tirzepatide daily for an additional $100 per month for each plan.

Can you prescribe Ozempic®* or Wegovy®*?

Our providers focus on personalized medications and dosages that aren’t commercially available at your local pharmacy. While we don’t prescribe Ozempic®* or Wegovy®* directly, we may prescribe treatments containing the same active ingredient. These medications are specially compounded for you by a licensed pharmacy to meet your specific needs.

Are video visits with a provider required?

Our providers will review your information 100% online. Depending on where you live and the specifics of your medical history, our providers may require you to have a video visit or asynchronous visit via text message. If prescribed, you’ll get unlimited online access to message your provider as needed for follow-ups, adjustments, and answers to your questions.

What states do you serve?

Currently, we do not serve Arkansas, Connecticut, and New Mexico. However, we are always working to expand our reach, so stay in touch with us at hi@getcurex.com.

Made in Webflow