Does Blue Cross of Idaho Cover Eliquis

Explore if Blue Cross of Idaho covers Eliquis, reasons for denial, tips to secure coverage, costs without insurance, and answers to common questions.
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Coverage for Eliquis by Blue Cross of Idaho

 

  • Blue Cross of Idaho provides coverage for Eliquis under their prescription drug benefits. Coverage often varies depending on the specific health plan, so it's important to check the details of your individual policy.
  •  

  • Typically, Eliquis is covered for individuals who have conditions such as atrial fibrillation, deep vein thrombosis, or pulmonary embolism. These conditions should be medically documented for the coverage to apply.
  •  

  • Coverage might require prior authorization. Your healthcare provider may need to submit a request demonstrating the medical necessity of Eliquis based on your condition and health history.
  •  

  • Some plans may require you to first try other medications (step therapy) before approving Eliquis, unless your doctor provides a strong justification against such options.
  •  

  • Co-pays or coinsurance fees can be expected, and these will vary with the tier of your plan. The cost-sharing depends on whether Eliquis is a preferred or non-preferred medication in your policy's formulary.

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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.

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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 Blue Cross of Idaho

 

Determine Eligibility for Coverage

 

  • Verify your current plan with Blue Cross of Idaho to see if prescription drug coverage is included.
  •  

  • Check the formulary list on Blue Cross of Idaho's website or contact their customer service to confirm that Eliquis is covered under your current plan.

 

 

Consult with Your Healthcare Provider

 

  • Discuss your medical needs with your doctor to ensure Eliquis is the appropriate medication for your condition.
  •  

  • Request a prescription for Eliquis from your healthcare provider to submit to your insurance plan.

 

 

Prepare Necessary Documentation

 

  • Gather required documents such as your insurance information, identification, and any necessary medical records supporting the need for Eliquis.
  •  

  • If needed, ask your healthcare provider for any additional documentation that Blue Cross of Idaho may require, such as prior authorization forms.

 

 

Contact Blue Cross of Idaho

 

  • Call the customer service number on the back of your insurance card for assistance specific to your plan.
  •  

  • Inquire about the steps needed to apply for coverage of Eliquis, including any forms or pre-approval needed.

 

 

Submit Prior Authorization, If Required

 

  • If a prior authorization is required, work with your healthcare provider to complete and submit the necessary forms to Blue Cross of Idaho.
  •  

  • Ensure all paperwork is filled out accurately and completely to avoid processing delays.

 

 

Review Approval and Coverage Terms

 

  • Once your application or prior authorization is processed, review the approval details received from Blue Cross of Idaho.
  •  

  • Understand any coverage limits, co-pays, or conditions that may apply specifically to Eliquis.

 

 

Fill Your Prescription

 

  • Take your prescription to a pharmacy that participates with Blue Cross of Idaho to ensure you receive any available benefits.
  •  

  • Provide your insurance information to the pharmacist and confirm your out-of-pocket cost before proceeding with the purchase.

 

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FAQs

Does Blue Cross of Idaho Cover Eliquis

Explore if Blue Cross of Idaho covers Eliquis, reasons for denial, tips to secure coverage, costs without insurance, and answers to common questions.
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Is Eliquis Covered by Blue Cross of Idaho

 

Coverage for Eliquis by Blue Cross of Idaho

 

  • Blue Cross of Idaho provides coverage for Eliquis under their prescription drug benefits. Coverage often varies depending on the specific health plan, so it's important to check the details of your individual policy.
  •  

  • Typically, Eliquis is covered for individuals who have conditions such as atrial fibrillation, deep vein thrombosis, or pulmonary embolism. These conditions should be medically documented for the coverage to apply.
  •  

  • Coverage might require prior authorization. Your healthcare provider may need to submit a request demonstrating the medical necessity of Eliquis based on your condition and health history.
  •  

  • Some plans may require you to first try other medications (step therapy) before approving Eliquis, unless your doctor provides a strong justification against such options.
  •  

  • Co-pays or coinsurance fees can be expected, and these will vary with the tier of your plan. The cost-sharing depends on whether Eliquis is a preferred or non-preferred medication in your policy's formulary.

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Blue Cross of Idaho's Approved Criteria for Eliquis Coverage

 

Eligibility Criteria for Eliquis Coverage

 

  • Member must have a confirmed diagnosis that aligns with the FDA-approved indications for Eliquis use, such as non-valvular atrial fibrillation, deep vein thrombosis, pulmonary embolism, or for stroke prevention.
  •  

  • Prescribed by a licensed healthcare provider with either an initial prescription or continued treatment plan indicating Eliquis as a necessary option.
  •  

  • Demonstrated history of prior anticoagulation therapy intolerance or unsatisfactory therapeutic results with other medications unless specifically contraindicated.
  •  

  • Documented assessment indicating that the benefits of Eliquis over other anticoagulants are medically justified and meet Blue Cross of Idaho's formulary guidelines.
  •  

 

Dosage and Treatment Duration

 

  • Eliquis must be prescribed in accordance with the dosing guidelines approved by the FDA for the specific medical condition of the insured individual.
  •  

  • For ongoing coverage, periodic review of the patient's condition should demonstrate effective control or anticipated benefits of continued Eliquis treatment.
  •  

  • Adjustments in dosing and continued coverage may depend on regular monitoring of the patient's clinical response and potential side effects.
  •  

 

Additional Considerations for Coverage

 

  • The patient should not be using Eliquis concurrently with medications that significantly increase the risk of bleeding unless deemed necessary by a healthcare provider with a detailed written rationale.
  •  

  • Consideration of patient demographic factors such as age and co-morbid conditions to assess the appropriateness and safety of Eliquis therapy for individual cases.
  •  

  • The insurance coverage for Eliquis may require completion of a prior authorization process to affirm that all criteria are met per policy guidelines.
  •  

 

Why Blue Cross of Idaho Might Deny Eliquis Coverage

 

Criteria for Denial of Eliquis Coverage by Blue Cross of Idaho

 

  • **Non-FDA Approved Uses**: Blue Cross of Idaho may deny coverage for Eliquis if it is being prescribed for conditions that are not approved by the FDA.
  •  

  • **Off-Label Use**: Usage of Eliquis that is considered off-label without sufficient supporting documentation from the healthcare provider may lead to denial.
  •  

  • **Lack of Prior Authorization**: If the prescription requires prior authorization and this was not obtained, coverage may be denied.
  •  

  • **Non-Compliance with Step Therapy Protocols**: If the coverage policy requires the member to first try alternative medications, such as generics, before approving Eliquis, failure to comply can result in denial.
  •  

  • **Incomplete Documentation**: Coverage may be denied if the request lacks complete clinical documentation or fails to justify medical necessity according to the plan's criteria.
  •  

  • **Plan Exclusions**: If the specific plan excludes coverage for certain medications or therapeutic classes explicitly, Eliquis may not be covered.
  •  

  • **Non-Partnership Pharmacies**: Filling the prescription at a pharmacy that is not within the network or partnership of Blue Cross of Idaho could lead to rejection of coverage claims.

 

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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 Blue Cross of Idaho

 

Determine Eligibility for Coverage

 

  • Verify your current plan with Blue Cross of Idaho to see if prescription drug coverage is included.
  •  

  • Check the formulary list on Blue Cross of Idaho's website or contact their customer service to confirm that Eliquis is covered under your current plan.

 

 

Consult with Your Healthcare Provider

 

  • Discuss your medical needs with your doctor to ensure Eliquis is the appropriate medication for your condition.
  •  

  • Request a prescription for Eliquis from your healthcare provider to submit to your insurance plan.

 

 

Prepare Necessary Documentation

 

  • Gather required documents such as your insurance information, identification, and any necessary medical records supporting the need for Eliquis.
  •  

  • If needed, ask your healthcare provider for any additional documentation that Blue Cross of Idaho may require, such as prior authorization forms.

 

 

Contact Blue Cross of Idaho

 

  • Call the customer service number on the back of your insurance card for assistance specific to your plan.
  •  

  • Inquire about the steps needed to apply for coverage of Eliquis, including any forms or pre-approval needed.

 

 

Submit Prior Authorization, If Required

 

  • If a prior authorization is required, work with your healthcare provider to complete and submit the necessary forms to Blue Cross of Idaho.
  •  

  • Ensure all paperwork is filled out accurately and completely to avoid processing delays.

 

 

Review Approval and Coverage Terms

 

  • Once your application or prior authorization is processed, review the approval details received from Blue Cross of Idaho.
  •  

  • Understand any coverage limits, co-pays, or conditions that may apply specifically to Eliquis.

 

 

Fill Your Prescription

 

  • Take your prescription to a pharmacy that participates with Blue Cross of Idaho to ensure you receive any available benefits.
  •  

  • Provide your insurance information to the pharmacist and confirm your out-of-pocket cost before proceeding with the purchase.

 

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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.

 

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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.

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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.

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