Does EmblemHealth Cover Eliquis

Learn about EmblemHealth's Eliquis coverage, potential denials, alternatives, costs without insurance, and FAQs in our comprehensive guide.
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EmblemHealth Coverage for Eliquis

 

  • EmblemHealth generally covers prescription medications, including Eliquis, if deemed medically necessary. Coverage is subject to the specific plan and formulary.
  •  

  • Typically, Eliquis may require prior authorization to ensure that it's appropriate for the patient's condition.
  •  

  • Patients may need to demonstrate that alternative, less costly medications were ineffective or inappropriate for their condition.
  •  

  • To qualify for Eliquis coverage, patients should work with their healthcare provider to provide proper documentation supporting the necessity of the medication.
  •  

  • Costs will vary based on the specific plan, copayments, and deductibles. EmblemHealth provides different plan options which can affect out-of-pocket costs for medications.
    •  

      Steps to Ensure Coverage

       

      • Contact EmblemHealth customer service to verify if Eliquis is covered under your plan.
      •  

      • Work with your healthcare provider to submit any required prior authorization paperwork.
      •  

      • Check if there are any generic or alternative drugs covered that could meet your medical needs.

       

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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 EmblemHealth

 

Verify Your Plan Coverage

 

  • Begin by reviewing your current EmblemHealth policy to determine if Eliquis is covered. Refer to the Prescription Drug List (PDL) provided by EmblemHealth to confirm if Eliquis is included.
  •  

  • Check if your plan requires prior authorization or has restrictions such as quantity limits for Eliquis. This may affect how your medication is covered.

 

Consult Your Healthcare Provider

 

  • Discuss with your doctor why Eliquis is the appropriate medication for your condition and ensure they prescribe it accordingly.
  •  

  • Ask your doctor if they need to submit any medical documentation to justify Eliquis's necessity to meet any EmblemHealth requirements.

 

Contact EmblemHealth Customer Service

 

  • Reach out to EmblemHealth customer service to clarify any doubts about Eliquis coverage in your plan. Have your plan details ready for a more efficient process.
  •  

  • Inquire if there are specific forms or procedures you need to follow to ensure coverage for Eliquis.

 

Submit a Prior Authorization Request

 

  • If required, work with your doctor to complete and submit a prior authorization form to EmblemHealth. This includes providing the necessary medical documentation justifying the need for Eliquis.
  •  

  • Follow up with both your doctor and EmblemHealth to confirm the status of the request submission and approval.

 

Understand Your Costs

 

  • Once authorized, review your EmblemHealth plan details to understand your out-of-pocket costs or copayments for Eliquis.
  •  

  • Consider using EmblemHealth’s online tools or contacting them directly for a detailed breakdown of costs associated with filling your Eliquis prescription.

 

Explore Assistance Programs

 

  • If Eliquis is not fully covered or is too costly, research patient assistance programs offered by the manufacturer for potential discounts or savings.
  •  

  • Consult with your doctor or pharmacist for additional resources or alternative medication options that EmblemHealth might cover more extensively.

 

Review and Fill Your Prescription

 

  • After confirming coverage and costs, fill your Eliquis prescription at a pharmacy that partners with EmblemHealth to ensure optimal coverage benefits.
  •  

  • Keep a record of your prescription fills and any communications with EmblemHealth for future reference or potential disputes.

 

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FAQs

Does EmblemHealth Cover Eliquis

Learn about EmblemHealth's Eliquis coverage, potential denials, alternatives, costs without insurance, and FAQs in our comprehensive guide.
Curex allergy drops unboxing

Is Eliquis Covered by EmblemHealth

 

EmblemHealth Coverage for Eliquis

 

  • EmblemHealth generally covers prescription medications, including Eliquis, if deemed medically necessary. Coverage is subject to the specific plan and formulary.
  •  

  • Typically, Eliquis may require prior authorization to ensure that it's appropriate for the patient's condition.
  •  

  • Patients may need to demonstrate that alternative, less costly medications were ineffective or inappropriate for their condition.
  •  

  • To qualify for Eliquis coverage, patients should work with their healthcare provider to provide proper documentation supporting the necessity of the medication.
  •  

  • Costs will vary based on the specific plan, copayments, and deductibles. EmblemHealth provides different plan options which can affect out-of-pocket costs for medications.
    •  

      Steps to Ensure Coverage

       

      • Contact EmblemHealth customer service to verify if Eliquis is covered under your plan.
      •  

      • Work with your healthcare provider to submit any required prior authorization paperwork.
      •  

      • Check if there are any generic or alternative drugs covered that could meet your medical needs.

       

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EmblemHealth's Approved Criteria for Eliquis Coverage

 

Eliquis Coverage Criteria by EmblemHealth

 

  • Individuals must be at least 18 years old.
  •  

  • Prescribed for approved indications such as:
    • Prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.
    • Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE).
    • Reduction in risk of recurrence of DVT and PE following initial therapy.
    • Prophylaxis of DVT, which may lead to PE in patients who have undergone hip or knee replacement surgery.
  •  

  • Documentation required from the prescribing healthcare provider that includes:
    • Diagnosis aligning with one of the approved indications.
    • Previous anticoagulation therapy history, if applicable.
    • Underlying health conditions influencing anticoagulation treatment, such as renal function.
  •  

  • Prior authorization may be necessary based on the patient's health plan specifics.
  •  

  • Consideration of any contraindications that the patient may have with other anticoagulants, supporting the need for Eliquis specifically.
  •  

  • If Eliquis is part of a therapeutic strategy involving a switch from another anticoagulant, there should be rationale provided for this switch.
  •  

 

Why EmblemHealth Might Deny Eliquis Coverage

 

Criteria for Denying Eliquis Coverage by EmblemHealth

 

  • Prescription does not meet the medical criteria established by EmblemHealth's formulary guidelines for Eliquis use.
  •  

  • The patient has not tried and failed on other preferred anticoagulants before requesting Eliquis, if applicable under step therapy requirements.
  •  

  • Eliquis is prescribed for a condition that is not covered under EmblemHealth's formulary or does not have sufficient clinical evidence for its effectiveness as determined by EmblemHealth.
  •  

  • The prescription is for an off-label use of Eliquis that is not supported by strong clinical evidence or not approved by EmblemHealth’s policies.
  •  

  • Prescribed dosage or duration of Eliquis does not align with EmblemHealth’s prescription guidelines, including any limits on dosage strength or treatment duration.
  •  

  • The patient has not met prior authorization requirements deemed necessary for coverage by EmblemHealth.
  •  

  • Eliquis is deemed not medically necessary for the patient based on the provided clinical information and assessment by EmblemHealth.
  •  

  • There is an issue with the prescriber's legitimacy, such as lack of proper credentials or not being within EmblemHealth's network of healthcare providers, when required.

 

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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 EmblemHealth

 

Verify Your Plan Coverage

 

  • Begin by reviewing your current EmblemHealth policy to determine if Eliquis is covered. Refer to the Prescription Drug List (PDL) provided by EmblemHealth to confirm if Eliquis is included.
  •  

  • Check if your plan requires prior authorization or has restrictions such as quantity limits for Eliquis. This may affect how your medication is covered.

 

Consult Your Healthcare Provider

 

  • Discuss with your doctor why Eliquis is the appropriate medication for your condition and ensure they prescribe it accordingly.
  •  

  • Ask your doctor if they need to submit any medical documentation to justify Eliquis's necessity to meet any EmblemHealth requirements.

 

Contact EmblemHealth Customer Service

 

  • Reach out to EmblemHealth customer service to clarify any doubts about Eliquis coverage in your plan. Have your plan details ready for a more efficient process.
  •  

  • Inquire if there are specific forms or procedures you need to follow to ensure coverage for Eliquis.

 

Submit a Prior Authorization Request

 

  • If required, work with your doctor to complete and submit a prior authorization form to EmblemHealth. This includes providing the necessary medical documentation justifying the need for Eliquis.
  •  

  • Follow up with both your doctor and EmblemHealth to confirm the status of the request submission and approval.

 

Understand Your Costs

 

  • Once authorized, review your EmblemHealth plan details to understand your out-of-pocket costs or copayments for Eliquis.
  •  

  • Consider using EmblemHealth’s online tools or contacting them directly for a detailed breakdown of costs associated with filling your Eliquis prescription.

 

Explore Assistance Programs

 

  • If Eliquis is not fully covered or is too costly, research patient assistance programs offered by the manufacturer for potential discounts or savings.
  •  

  • Consult with your doctor or pharmacist for additional resources or alternative medication options that EmblemHealth might cover more extensively.

 

Review and Fill Your Prescription

 

  • After confirming coverage and costs, fill your Eliquis prescription at a pharmacy that partners with EmblemHealth to ensure optimal coverage benefits.
  •  

  • Keep a record of your prescription fills and any communications with EmblemHealth for future reference or potential disputes.

 

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

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

Titration

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

Additional Treatments

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

Got questions? We have answers.

Do your plans include prescriptions and medications?

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

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

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

What medications do your providers prescribe?

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

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

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

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

Will I be prescribed semaglutide if I sign up?

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

What is compounded medication?

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

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

Is compounded medication the same as generic medication?

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

Is insurance required?

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

Can I pay with an FSA or HSA card?

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

How much does treatment cost?

Semaglutide Injections:

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

Tirzepatide Injections:

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

Semaglutide Tablets:

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

Tirzepatide Tablets:

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

Can you prescribe Ozempic®* or Wegovy®*?

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

Are video visits with a provider required?

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

What states do you serve?

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

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