Does Cigna Cover Eliquis

Discover if Cigna covers Eliquis, reasons for denial, ways to secure coverage, costs without insurance, and find answers to common questions.
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Does Cigna Cover Eliquis?

 

  • Cigna generally covers Eliquis for patients under their Medicare Part D and commercial insurance plans, but specific coverage depends on the individual's plan and location.
  •  

  • Approval for Eliquis coverage typically requires a prior authorization process. This involves the prescribing physician submitting information that confirms the medical necessity of Eliquis for the patient.
  •  

  • Patients must usually have a condition Eliquis is approved to treat, such as atrial fibrillation, deep vein thrombosis, or pulmonary embolism.
  •  

  • Cost-sharing rules involve copayments or coinsurance, which vary by plan. Patients may need to try alternative anticoagulants first unless medical justification is provided.
  •  

  • Cigna's formulary determines coverage details and is subject to annual updates, so beneficiaries should consult their specific plan's formulary for the most accurate information.

 

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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 Cigna

 

Check Cigna Coverage for Eliquis

 

  • Visit the Cigna website or log into your Cigna account to review your pharmacy benefits.
  •  

  • Look up your specific plan to see if Eliquis is covered under the formulary list. A formulary is a list of medications covered by your insurance plan.
  •  

  • Contact Cigna customer service directly at the number provided on your insurance card for confirmation if you cannot find the information online.

 

Consult with Your Physician

 

  • Schedule an appointment with your doctor to discuss your need for Eliquis. Make sure to inform them that you're specifically interested in obtaining coverage through Cigna.
  •  

  • Ask your doctor to prescribe Eliquis with any necessary justification, such as a prior authorization request if required by Cigna.

 

Understand Prior Authorization Requirements

 

  • Prior authorization may be required for Eliquis. Have your healthcare provider submit a prior authorization request to Cigna, including documentation that supports the medical necessity of Eliquis.
  •  

  • Familiarize yourself with the prior authorization process by reviewing Cigna's guidelines, which might be available on their website.

 

Explore Generic or Alternative Medications

 

  • Inquire with Cigna or your healthcare provider if there are any generic versions of Eliquis available, as they might have better coverage.
  •  

  • Discuss alternative medications with your doctor that have similar therapeutic effects and are covered under your plan.

 

Appeal if Your Claim is Denied

 

  • If your request for Eliquis coverage is initially denied, don't give up. Cigna provides an appeals process for denied claims.
  •  

  • Gather supporting documentation from your doctor and submit an appeal to Cigna, explaining why Eliquis is medically necessary for you.
  •  

  • Follow up regularly on the status of your appeal and be prepared to provide additional information if needed.

 

Utilize Prescription Assistance Programs

 

  • If coverage through Cigna is not feasible, explore manufacturer's patient assistance programs or other prescription savings programs for Eliquis, which might provide the medication at a reduced cost or for free.
  •  

  • Check if you qualify based on income or insurance status and apply directly through these programs.

 

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FAQs

Does Cigna Cover Eliquis

Discover if Cigna covers Eliquis, reasons for denial, ways to secure coverage, costs without insurance, and find answers to common questions.
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Is Eliquis Covered by Cigna

 

Does Cigna Cover Eliquis?

 

  • Cigna generally covers Eliquis for patients under their Medicare Part D and commercial insurance plans, but specific coverage depends on the individual's plan and location.
  •  

  • Approval for Eliquis coverage typically requires a prior authorization process. This involves the prescribing physician submitting information that confirms the medical necessity of Eliquis for the patient.
  •  

  • Patients must usually have a condition Eliquis is approved to treat, such as atrial fibrillation, deep vein thrombosis, or pulmonary embolism.
  •  

  • Cost-sharing rules involve copayments or coinsurance, which vary by plan. Patients may need to try alternative anticoagulants first unless medical justification is provided.
  •  

  • Cigna's formulary determines coverage details and is subject to annual updates, so beneficiaries should consult their specific plan's formulary for the most accurate information.

 

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Cigna's Approved Criteria for Eliquis Coverage

 

Cigna's Criteria for Eliquis Coverage

 

  • The patient has a diagnosis of non-valvular atrial fibrillation and requires Eliquis for stroke and systemic embolism prevention.
  •  

  • The patient has been diagnosed with deep vein thrombosis (DVT) or pulmonary embolism (PE) and requires Eliquis for treatment and risk reduction of recurrence.
  •  

  • The patient is undergoing hip or knee replacement surgery and requires Eliquis for the prevention of DVT and PE.
  •  

  • There should be documented intolerance, contraindication, or inadequate response to other anticoagulant therapies if Eliquis is prescribed as the first-line treatment.
  •  

  • The prescribing physician must provide detailed documentation, including diagnosis, previous therapies tried, and clinical justification for choosing Eliquis over other anticoagulants.
  •  

  • For continued coverage, the patient must demonstrate adherence to the medication regimen and have regular follow-up consultations to assess the efficacy and safety of the treatment.

 

Why Cigna Might Deny Eliquis Coverage

 

Reasons Cigna Might Deny Eliquis Coverage

 

  • Eliquis prescription does not meet Cigna's medical necessity criteria. This assessment depends on the patient's specific medical condition and health needs not aligning with Cigna's established guidelines for Eliquis use.
  •  

  • The prescription is for an off-label use of Eliquis. Cigna typically adheres to FDA-approved uses or other accepted medical practices, and coverage might not extend to unapproved uses of the drug.
  •  

  • Absence of prior authorization. Cigna may require prior authorization for Eliquis, and failure to obtain this before filling the prescription can lead to denial of coverage.
  •  

  • Non-compliance with step therapy requirements. These protocols demand trying and failing cheaper or preferred alternative medications before Eliquis will be considered for coverage.
  •  

  • Quantity limits have been exceeded. Cigna may deny coverage if the prescription surpasses the allowed monthly supply, aiming to ensure safe and effective use of the medication.
  •  

  • Eligibility constraints. If a patient's current plan does not include coverage for certain medications like Eliquis, this could lead to a denial.

 

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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 Cigna

 

Check Cigna Coverage for Eliquis

 

  • Visit the Cigna website or log into your Cigna account to review your pharmacy benefits.
  •  

  • Look up your specific plan to see if Eliquis is covered under the formulary list. A formulary is a list of medications covered by your insurance plan.
  •  

  • Contact Cigna customer service directly at the number provided on your insurance card for confirmation if you cannot find the information online.

 

Consult with Your Physician

 

  • Schedule an appointment with your doctor to discuss your need for Eliquis. Make sure to inform them that you're specifically interested in obtaining coverage through Cigna.
  •  

  • Ask your doctor to prescribe Eliquis with any necessary justification, such as a prior authorization request if required by Cigna.

 

Understand Prior Authorization Requirements

 

  • Prior authorization may be required for Eliquis. Have your healthcare provider submit a prior authorization request to Cigna, including documentation that supports the medical necessity of Eliquis.
  •  

  • Familiarize yourself with the prior authorization process by reviewing Cigna's guidelines, which might be available on their website.

 

Explore Generic or Alternative Medications

 

  • Inquire with Cigna or your healthcare provider if there are any generic versions of Eliquis available, as they might have better coverage.
  •  

  • Discuss alternative medications with your doctor that have similar therapeutic effects and are covered under your plan.

 

Appeal if Your Claim is Denied

 

  • If your request for Eliquis coverage is initially denied, don't give up. Cigna provides an appeals process for denied claims.
  •  

  • Gather supporting documentation from your doctor and submit an appeal to Cigna, explaining why Eliquis is medically necessary for you.
  •  

  • Follow up regularly on the status of your appeal and be prepared to provide additional information if needed.

 

Utilize Prescription Assistance Programs

 

  • If coverage through Cigna is not feasible, explore manufacturer's patient assistance programs or other prescription savings programs for Eliquis, which might provide the medication at a reduced cost or for free.
  •  

  • Check if you qualify based on income or insurance status and apply directly through these programs.

 

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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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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.

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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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