Does Christiana Care Health System Cover Eliquis

Explore Eliquis coverage by Christiana Care, why it might be denied, obtaining coverage, costs without insurance, and answers to common questions.
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Christiana Care Coverage for Eliquis

 

  • Christiana Care Health System provides coverage for Eliquis under specific conditions, particularly for patients with atrial fibrillation, deep vein thrombosis, or pulmonary embolism.
  •  

  • To receive coverage, patients typically need a prescription from a healthcare provider within the Christiana Care network.
  •  

  • Insurance plans associated with Christiana Care may require prior authorization to ensure the medication is needed based on medical criteria.
  •  

  • Patients might need to meet certain eligibility criteria, such as having tried other anticoagulants without success, or having specific risk factors that necessitate Eliquis.
  •  

  • Coverage is often dependent on the patient's specific plan and may involve copays or out-of-pocket costs.

 

Steps to Verify Coverage

 

  • Consult with your Christiana Care healthcare provider to determine if Eliquis is appropriate for your condition.
  •  

  • Contact Christiana Care's insurance support or your specific plan provider for details on coverage criteria and financial obligations.
  •  

  • Ensure all necessary paperwork and prior authorizations are completed before obtaining your prescription.

 

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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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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.

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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 Christiana Care Health System

 

Start by Contacting Christiana Care Health System

 

  • Begin by reaching out to Christiana Care Health System's customer service or patient support. This ensures that you gather accurate information about their coverage options for Eliquis.
  •  

  • Ask for any specific forms, applications, or documentation you might need to submit to seek coverage for Eliquis.

 

Check Your Current Insurance Plan

 

  • Review your current health insurance policy to understand if there is any existing coverage for prescription drugs, particularly Eliquis.
  •  

  • If you have a health insurance plan that includes prescription drug coverage, contact your insurance company to get details on how Eliquis is covered under your plan.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider affiliated with Christiana Care Health System to discuss your need for Eliquis.
  •  

  • Request a prescription verification letter from your doctor explaining the medical necessity for Eliquis. This document can be pivotal in securing insurance approval.

 

Explore Financial Assistance Programs

 

  • Inquire about any financial assistance programs offered by Christiana Care Health System or external organizations that may help cover the cost of Eliquis.
  •  

  • Look into the possibility of manufacturer discount programs, patient assistance programs, or foundation grants that assist in covering the cost of Eliquis.

 

Gather Required Documentation

 

  • Compile all the required documentation, including your prescription verification letter, health insurance information, financial assistance forms, and any other paperwork requested by Christiana Care Health System.
  •  

  • Ensure that all documents are complete and accurate to avoid any delays in processing your application for coverage.

 

Submit Your Application for Coverage

 

  • Submit your completed application and all accompanying documents to Christiana Care Health System for review.
  •  

  • Follow up with the healthcare system’s patient services department to ensure your application is being processed and determine if any additional information is needed.

 

Follow up on Your Application Status

 

  • Stay in touch with the relevant departments at Christiana Care Health System and your insurance provider to keep track of the status of your application for Eliquis coverage.
  •  

  • Regularly check for updates, and be prepared to provide any additional documentation or information if requested.

 

Review and Appeal If Necessary

 

  • If your application for coverage is denied, review the reasons provided for the denial carefully.
  •  

  • Consult with Christiana Care Health System’s patient advocacy services to understand the appeals process and secure assistance in submitting an appeal for coverage.
  •  

  • Provide any additional documentation or clarification required during the appeals process to strengthen your case for coverage.

 

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FAQs

Does Christiana Care Health System Cover Eliquis

Explore Eliquis coverage by Christiana Care, why it might be denied, obtaining coverage, costs without insurance, and answers to common questions.
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Is Eliquis Covered by Christiana Care Health System

 

Christiana Care Coverage for Eliquis

 

  • Christiana Care Health System provides coverage for Eliquis under specific conditions, particularly for patients with atrial fibrillation, deep vein thrombosis, or pulmonary embolism.
  •  

  • To receive coverage, patients typically need a prescription from a healthcare provider within the Christiana Care network.
  •  

  • Insurance plans associated with Christiana Care may require prior authorization to ensure the medication is needed based on medical criteria.
  •  

  • Patients might need to meet certain eligibility criteria, such as having tried other anticoagulants without success, or having specific risk factors that necessitate Eliquis.
  •  

  • Coverage is often dependent on the patient's specific plan and may involve copays or out-of-pocket costs.

 

Steps to Verify Coverage

 

  • Consult with your Christiana Care healthcare provider to determine if Eliquis is appropriate for your condition.
  •  

  • Contact Christiana Care's insurance support or your specific plan provider for details on coverage criteria and financial obligations.
  •  

  • Ensure all necessary paperwork and prior authorizations are completed before obtaining your prescription.

 

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Christiana Care Health System's Approved Criteria for Eliquis Coverage

 

Criteria for Eliquis Coverage at Christiana Care Health System

 

  • **Diagnosis of Atrial Fibrillation:** Patient must have a documented diagnosis of non-valvular atrial fibrillation to reduce the risk of stroke and systemic embolism.
  •  

  • **Treatment of Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE):** The patient must require Eliquis for the treatment and prevention of recurrence of DVT or PE.
  •  

  • **Surgical or Medical History:** Patients who are undergoing hip or knee replacement surgery and have a need for prophylaxis to prevent DVT are covered under this criterion.
  •  

  • **Prior Authorization Form:** Completion and submission of a prior authorization form specifying the necessity of Eliquis for the patient.
  •  

  • **Trial and Failure of Other Anticoagulants:** Demonstrated trial and failure, contraindication, or intolerance to at least one other anticoagulant medication like warfarin, heparin, or other direct oral anticoagulants.
  •  

  • **Evaluation of Renal Function:** Patients must have a documented assessment of their renal function before starting Eliquis to ensure proper dosage decisions.
  •  

  • **Provider Attestation:** Prescription by a healthcare provider with attestation regarding the necessity based on the patient's medical condition and history.
  •  

  • **Contraindications Assessment:** Patient does not have life-threatening hemorrhage or other contraindications for use outlined by healthcare providers.
  •  

  • **Clinician Agreement:** Documentation of agreement from a consulting specialist if the prescribing provider is not a specialist in cardiovascular health or hematology.

 

Why Christiana Care Health System Might Deny Eliquis Coverage

 

Criteria for Denial of Eliquis Coverage by Christiana Care Health System

 

  • Prescription falls outside of FDA-approved indications for use. This includes any off-label prescribing practices that do not align with recognized medical guidelines and standards considered necessary by the Health System.
  •  

  • Failure to comply with prior authorization requirements, such as not providing sufficient clinical evidence or necessary documentation demonstrating the medical necessity of Eliquis for the patient.
  •  

  • Lack of adherence to step therapy protocols, where alternative medications have not been tried and failed before prescribing Eliquis. This might involve the requirement to try generic or other cost-effective treatments before coverage for Eliquis can be approved.
  •  

  • Patient does not meet specific clinical criteria outlined in the health plan's formulary guidelines, which may include age restrictions, contraindications due to other health conditions, or having specific types of insurance plans.
  •  

  • Policy exclusions related to pre-existing conditions or medical history that make the use of Eliquis unnecessary or potentially harmful according to plan standards 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 Christiana Care Health System

 

Start by Contacting Christiana Care Health System

 

  • Begin by reaching out to Christiana Care Health System's customer service or patient support. This ensures that you gather accurate information about their coverage options for Eliquis.
  •  

  • Ask for any specific forms, applications, or documentation you might need to submit to seek coverage for Eliquis.

 

Check Your Current Insurance Plan

 

  • Review your current health insurance policy to understand if there is any existing coverage for prescription drugs, particularly Eliquis.
  •  

  • If you have a health insurance plan that includes prescription drug coverage, contact your insurance company to get details on how Eliquis is covered under your plan.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider affiliated with Christiana Care Health System to discuss your need for Eliquis.
  •  

  • Request a prescription verification letter from your doctor explaining the medical necessity for Eliquis. This document can be pivotal in securing insurance approval.

 

Explore Financial Assistance Programs

 

  • Inquire about any financial assistance programs offered by Christiana Care Health System or external organizations that may help cover the cost of Eliquis.
  •  

  • Look into the possibility of manufacturer discount programs, patient assistance programs, or foundation grants that assist in covering the cost of Eliquis.

 

Gather Required Documentation

 

  • Compile all the required documentation, including your prescription verification letter, health insurance information, financial assistance forms, and any other paperwork requested by Christiana Care Health System.
  •  

  • Ensure that all documents are complete and accurate to avoid any delays in processing your application for coverage.

 

Submit Your Application for Coverage

 

  • Submit your completed application and all accompanying documents to Christiana Care Health System for review.
  •  

  • Follow up with the healthcare system’s patient services department to ensure your application is being processed and determine if any additional information is needed.

 

Follow up on Your Application Status

 

  • Stay in touch with the relevant departments at Christiana Care Health System and your insurance provider to keep track of the status of your application for Eliquis coverage.
  •  

  • Regularly check for updates, and be prepared to provide any additional documentation or information if requested.

 

Review and Appeal If Necessary

 

  • If your application for coverage is denied, review the reasons provided for the denial carefully.
  •  

  • Consult with Christiana Care Health System’s patient advocacy services to understand the appeals process and secure assistance in submitting an appeal for coverage.
  •  

  • Provide any additional documentation or clarification required during the appeals process to strengthen your case for coverage.

 

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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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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.

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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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