Does Centene Corporation Cover Eliquis

Explore Centene's Eliquis coverage, reasons for denial, costs without insurance, and FAQs in our comprehensive guide for better access to this medication.
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Centene Corporation Coverage for Eliquis

 

  • Centene Corporation typically covers Eliquis for patients who require anticoagulation therapy. It is usually prescribed for the treatment and prevention of blood clots, including conditions such as atrial fibrillation, deep vein thrombosis, and pulmonary embolism.
  •  

  • Coverage and criteria may vary depending on the specific health insurance plan under Centene Corporation. Patients may need prior authorization to ensure that Eliquis is deemed medically necessary.
  •  

  • Basic rules for coverage often include confirmation of diagnosis, documentation of previous treatments, and trials of other anticoagulants, if applicable, before Eliquis is approved.
  •  

  • Patients may need to work closely with their healthcare provider to submit necessary paperwork and evidence that Eliquis is the appropriate treatment option.

 

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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.

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

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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 Centene Corporation

 

Contact Centene Corporation Customer Service

 

  • Find the contact details for Centene Corporation, which should be available on their official website or on any documents you might have received from them.
  •  

  • Call the customer service number or use their online contact form to inquire about specific plans that may cover Eliquis.

 

Verify Your Eligibility

 

  • Discuss your current healthcare plan options with the customer service representative.
  •  

  • Confirm whether your current plan covers Eliquis, or if there is a specific plan that includes it.

 

Review Your Insurance Plan Options

 

  • Request detailed information on insurance plans that Centene offers, ensuring to ask specifically about pharmaceutical coverage.
  •  

  • Pay close attention to plans that include comprehensive drug coverage, as these are more likely to cover Eliquis.

 

Consider Plan Enrollment

 

  • If necessary, discuss the process of enrolling in a plan that includes Eliquis, especially if your current plan does not cover it.
  •  

  • Review the eligibility criteria, enrollment periods, and any waiting periods that may apply.

 

Consult Your Healthcare Provider

 

  • Discuss with your healthcare provider about the necessity of Eliquis in your treatment plan.
  •  

  • Ask your provider if they can provide any supporting documentation or medical evidence that can assist in getting Eliquis covered by the insurer.

 

Submit a Coverage Request

 

  • If Eliquis is not covered under your current plan, submit a formal coverage request to Centene Corporation.
  •  

  • Include all necessary medical documentation and any letters of medical necessity from your healthcare provider.

 

Follow-Up with Centene Corporation

 

  • After submitting your request, proactively follow up with Centene to get updates on the status of your coverage request.
  •  

  • Work with your healthcare provider to respond to any additional requests for information from the insurer.

 

Appeal a Denied Request

 

  • If your request for coverage is denied, inquire about the appeals process.
  •  

  • Prepare and submit an appeal, including any additional evidence or arguments for why Eliquis is necessary for your health condition.

 

Utilize Patient Assistance Programs

 

  • If coverage through Centene is not an option, explore patient assistance programs offered by pharmaceutical companies that may offer Eliquis at a reduced cost or even for free for qualified patients.
  •  

  • Coordinate with your healthcare provider to ensure you meet the program criteria and complete any required documentation.

 

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FAQs

Does Centene Corporation Cover Eliquis

Explore Centene's Eliquis coverage, reasons for denial, costs without insurance, and FAQs in our comprehensive guide for better access to this medication.
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Is Eliquis Covered by Centene Corporation

 

Centene Corporation Coverage for Eliquis

 

  • Centene Corporation typically covers Eliquis for patients who require anticoagulation therapy. It is usually prescribed for the treatment and prevention of blood clots, including conditions such as atrial fibrillation, deep vein thrombosis, and pulmonary embolism.
  •  

  • Coverage and criteria may vary depending on the specific health insurance plan under Centene Corporation. Patients may need prior authorization to ensure that Eliquis is deemed medically necessary.
  •  

  • Basic rules for coverage often include confirmation of diagnosis, documentation of previous treatments, and trials of other anticoagulants, if applicable, before Eliquis is approved.
  •  

  • Patients may need to work closely with their healthcare provider to submit necessary paperwork and evidence that Eliquis is the appropriate treatment option.

 

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Centene Corporation's Approved Criteria for Eliquis Coverage

 

Centene Corporation's Approved Criteria for Eliquis Coverage

 

  • The member must be diagnosed with Non-Valvular Atrial Fibrillation (NVAF) and require anticoagulation therapy to reduce the risk of stroke and systemic embolism.
  •  

  • The member may be prescribed Eliquis for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), as well as to reduce the risk of recurrent DVT and PE following initial therapy.
  •  

  • Eliquis may be covered for patients requiring prophylaxis of DVT following hip or knee replacement surgery.
  •  

  • The prescribing physician must provide documentation indicating that Eliquis is the preferred oral anticoagulant based on the patient's clinical condition, considering known drug interactions, history of bleeding events, or specific patient factors such as liver function or need for predictable pharmacokinetics.
  •  

  • Coverage may be available for patients who have experienced intolerance or inadequate response to other anticoagulant therapies, such as warfarin or low molecular weight heparins.
  •  

  • The patient should not have significant renal impairment or contraindications for the use of direct oral anticoagulants (DOACs) based on their current medical evaluations.
  •  

  • The use of Eliquis should align with clinical guidelines for anticoagulation management approved by relevant national and international health organizations.
  •  

  • The treatment regimen and duration must be well-documented and justified by the health care provider, consistent with the recommended therapeutic protocols.
  •  

 

Why Centene Corporation Might Deny Eliquis Coverage

 

Reasons Centene Corporation Might Deny Eliquis Coverage

 

  • **Non-formulary Status:** If Eliquis is not included in the Centene Corporation's formulary list for certain plans or regions, coverage may be denied.
  •  

  • **Lack of Prior Authorization:** Coverage might be denied if prior authorization requirements are not met, meaning the necessary documentation or approval process has not been completed.
  •  

  • **Inappropriate Indication:** If Eliquis is prescribed for a condition not approved within Centene's policy guidelines, coverage might be refused.
  •  

  • **Therapeutic Alternatives:** If more cost-effective or therapeutically equivalent alternatives are listed in the formulary, Centene may refuse to cover Eliquis.
  •  

  • **Prescriber Authorization Issues:** Sometimes coverage could be denied if the prescription is not authorized by a healthcare provider within the network or if the provider does not meet specific authorization requirements.
  •  

  • **Out-of-Network Prescriptions:** If the prescription is filled at an out-of-network pharmacy or prescribed by an out-of-network doctor, coverage could be declined.
  •  

  • **Insufficient Medical Necessity Evidence:** If there is insufficient evidence of the medical necessity for Eliquis based on Centene's review criteria, coverage may be denied.
  •  

  • **Dosage or Usage Restrictions:** If Eliquis is prescribed outside of approved dosage limits or for durations not covered, it may lead to denial of coverage.

 

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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 Centene Corporation

 

Contact Centene Corporation Customer Service

 

  • Find the contact details for Centene Corporation, which should be available on their official website or on any documents you might have received from them.
  •  

  • Call the customer service number or use their online contact form to inquire about specific plans that may cover Eliquis.

 

Verify Your Eligibility

 

  • Discuss your current healthcare plan options with the customer service representative.
  •  

  • Confirm whether your current plan covers Eliquis, or if there is a specific plan that includes it.

 

Review Your Insurance Plan Options

 

  • Request detailed information on insurance plans that Centene offers, ensuring to ask specifically about pharmaceutical coverage.
  •  

  • Pay close attention to plans that include comprehensive drug coverage, as these are more likely to cover Eliquis.

 

Consider Plan Enrollment

 

  • If necessary, discuss the process of enrolling in a plan that includes Eliquis, especially if your current plan does not cover it.
  •  

  • Review the eligibility criteria, enrollment periods, and any waiting periods that may apply.

 

Consult Your Healthcare Provider

 

  • Discuss with your healthcare provider about the necessity of Eliquis in your treatment plan.
  •  

  • Ask your provider if they can provide any supporting documentation or medical evidence that can assist in getting Eliquis covered by the insurer.

 

Submit a Coverage Request

 

  • If Eliquis is not covered under your current plan, submit a formal coverage request to Centene Corporation.
  •  

  • Include all necessary medical documentation and any letters of medical necessity from your healthcare provider.

 

Follow-Up with Centene Corporation

 

  • After submitting your request, proactively follow up with Centene to get updates on the status of your coverage request.
  •  

  • Work with your healthcare provider to respond to any additional requests for information from the insurer.

 

Appeal a Denied Request

 

  • If your request for coverage is denied, inquire about the appeals process.
  •  

  • Prepare and submit an appeal, including any additional evidence or arguments for why Eliquis is necessary for your health condition.

 

Utilize Patient Assistance Programs

 

  • If coverage through Centene is not an option, explore patient assistance programs offered by pharmaceutical companies that may offer Eliquis at a reduced cost or even for free for qualified patients.
  •  

  • Coordinate with your healthcare provider to ensure you meet the program criteria and complete any required documentation.

 

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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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