Does Florida Blue (Blue Cross Blue Shield of Florida) Cover Eliquis

Explore Eliquis coverage with Florida Blue, potential denial reasons, how to secure coverage, costs without insurance, and get answers to common questions.
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Coverage for Eliquis by Florida Blue

 

  • Eliquis, a medication used for preventing blood clots and strokes, can be covered under certain Florida Blue health insurance plans.
  •  

  • Coverage typically depends on the specific plan you have. Check the formulary list or contact Florida Blue to confirm Eliquis is covered under your plan tier.
  •  

  • Pre-authorization may be needed, where your healthcare provider must demonstrate the medical necessity of Eliquis.
  •  

  • Drugs like Eliquis may require a doctor's prescription, and often, specific medical conditions like atrial fibrillation are considered for coverage.
  •  

  • For detailed information, it is important to refer directly to the benefits documentation of your particular policy or contact Florida Blue customer service directly.

 

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Curex is poised to revolutionize the way allergies are treated in America, expanding access to clinical care and treatments that can meaningfully improve patients quality of life.

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At Curex, our mission is to help people improve their health and quality of life by understanding their allergies and treating them at their source.We provide more than individualized prescription treatments; we provide individualized care.

Jill Hamburg, PA - C

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

Dr. Chet Tharpe, Medical Director

Curex has set the standard for the virtual allergy experience. From the comfort of their home, patients nationwide are able to receive a personalized treatment plan from an experienced clinician, aimed at treating the source of their allergies, not just the symptoms.

Kayla Mardaga, NP

Curex offers convenient at-home allergy testing options. Our goal is to determine if a patient would benefit from immunotherapy and then customize a treatment plan that can reduce both the symptoms and the reliance on allergy medications.

How to Get Eliquis Coverage with Florida Blue (Blue Cross Blue Shield of Florida)

 

Check Your Florida Blue Plan Formulary

 

  • Visit the Florida Blue website and access your plan’s formulary, which is a list of covered drugs. Make sure Eliquis is included.
  •  

  • Log into your Florida Blue member account to get personalized information if available.
  •  

  • If Eliquis is not listed, consider speaking with a Florida Blue representative about possible alternatives.

 

Consult with Your Doctor

 

  • Discuss with your doctor the necessity of Eliquis for your condition and ensure they provide the proper prescription specifics required by your insurance plan.
  •  

  • Inquire if a prior authorization is needed from Florida Blue for Eliquis.

 

Gather Necessary Documentation

 

  • Prepare all necessary documentation including prescription details and any medical diagnoses that support the need for Eliquis.
  •  

  • Have your doctor's contact information ready in case Florida Blue needs to initiate communication for additional information.

 

Contact Florida Blue Customer Service

 

  • Call the customer service number on your Florida Blue insurance card to discuss your prescription coverage options.
  •  

  • Inquire about the pre-approval process if required, and ask for specific forms that need to be filled out for Eliquis coverage.

 

Submit a Prior Authorization Request

 

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

  • Ensure that all sections are thoroughly filled and all required documentation is attached to prevent delays.

 

Appeal if Denied

 

  • If your request for coverage is denied, review the reason for denial provided by Florida Blue.
  •  

  • Work with your doctor to gather additional supporting information and submit an appeal or grievance with Florida Blue.

 

Explore Additional Assistance Programs

 

  • Consider looking into patient assistance programs offered by the manufacturer of Eliquis, which might offer financial help if the insurance coverage is insufficient.
  •  

  • Contact Florida Blue to see if they offer any additional prescription assistance programs.

 

Review and Re-Evaluate Annually

 

  • Each year, during open enrollment, review your Florida Blue plan and formulary to ensure that Eliquis coverage remains consistent.
  •  

  • Make adjustments as necessary, considering any changes in your healthcare needs.

 

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FAQs

Does Florida Blue (Blue Cross Blue Shield of Florida) Cover Eliquis

Explore Eliquis coverage with Florida Blue, potential denial reasons, how to secure coverage, costs without insurance, and get answers to common questions.
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Is Eliquis Covered by Florida Blue (Blue Cross Blue Shield of Florida)

 

Coverage for Eliquis by Florida Blue

 

  • Eliquis, a medication used for preventing blood clots and strokes, can be covered under certain Florida Blue health insurance plans.
  •  

  • Coverage typically depends on the specific plan you have. Check the formulary list or contact Florida Blue to confirm Eliquis is covered under your plan tier.
  •  

  • Pre-authorization may be needed, where your healthcare provider must demonstrate the medical necessity of Eliquis.
  •  

  • Drugs like Eliquis may require a doctor's prescription, and often, specific medical conditions like atrial fibrillation are considered for coverage.
  •  

  • For detailed information, it is important to refer directly to the benefits documentation of your particular policy or contact Florida Blue customer service directly.

 

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Florida Blue (Blue Cross Blue Shield of Florida)'s Approved Criteria for Eliquis Coverage

 

Eliquis Coverage Criteria by Florida Blue

 

  • **Indication for Treatment:** Coverage is approved for conditions such as nonvalvular atrial fibrillation, deep vein thrombosis (DVT), and pulmonary embolism (PE) where Eliquis is indicated.
  •  

  • **Prescription by Qualified Provider:** The prescription must be issued by a healthcare provider licensed to prescribe such medications, following appropriate medical assessment.
  •  

  • **Age Requirements:** The patient must be of appropriate age as specified in the medication guidelines, typically adults aged 18 years and older.
  •  

  • **Dosage Compliance:** The dosage prescribed should align with the approved labeling and indications for Eliquis, considering the patient's specific medical condition and other individual factors.
  •  

  • **Previous Treatment:** For conditions like DVT or PE, the patient may need to have tried alternative anticoagulants before obtaining coverage for Eliquis, unless contraindicated.
  •  

  • **Risk Evaluation:** Patients may require evaluation of bleeding risks associated with anticoagulant therapy, determining the appropriateness of Eliquis in comparison to other available options.
  •  

  • **Therapeutic Monitoring:** Coverage may include requirements for periodic review and assessment of the medication's effectiveness and safety in managing the indicated condition.
  •  

  • **Special Circumstances:** In certain instances, like a documented allergy or adverse reaction to other anticoagulants, coverage for Eliquis may be considered directly, subject to medical justification.

 

Why Florida Blue (Blue Cross Blue Shield of Florida) Might Deny Eliquis Coverage

 

Circumstances for Denial of Eliquis Coverage by Florida Blue

 

  • **Non-Medical Necessity**: If Florida Blue determines that Eliquis is not medically necessary, they may deny coverage. This could occur if there is insufficient documentation to support the need for Eliquis or if an alternative treatment option is deemed more appropriate.
  •  

  • **Non-Formulary Drug**: Eliquis might not be included in Florida Blue's drug formulary. If it's not listed, coverage may be denied unless a medical exception is obtained.
  •  

  • **Prior Authorization Requirements**: If the prescription for Eliquis does not meet the specific prior authorization requirements set by Florida Blue, coverage may be denied. This might include lack of necessary pre-approval from the insurer before the medication is dispensed.
  •  

  • **Step Therapy Protocols**: Florida Blue may have step therapy protocols requiring patients to first try less expensive medications before progressing to Eliquis. Failure to meet these protocols could result in a denial of coverage.
  •  

  • **Plan Exclusions or Limitations**: Some insurance plans might explicitly exclude certain drugs or have limitations based on specific terms, conditions, or rider exceptions within the policy coverage details.
  •  

  • **Non-Compliance With Policy Terms**: If the subscriber fails to comply with the terms and conditions of the health insurance policy, such as not following the proper procedures for getting prescriptions filled or lack of adherence to logistical requirements, this can lead to denial of coverage.
  •  

  • **Out-of-Network Prescriptions**: If Eliquis is prescribed by a healthcare provider not within the Florida Blue network, and the plan doesn't cover out-of-network benefits, the claim might be denied.

 

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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 Florida Blue (Blue Cross Blue Shield of Florida)

 

Check Your Florida Blue Plan Formulary

 

  • Visit the Florida Blue website and access your plan’s formulary, which is a list of covered drugs. Make sure Eliquis is included.
  •  

  • Log into your Florida Blue member account to get personalized information if available.
  •  

  • If Eliquis is not listed, consider speaking with a Florida Blue representative about possible alternatives.

 

Consult with Your Doctor

 

  • Discuss with your doctor the necessity of Eliquis for your condition and ensure they provide the proper prescription specifics required by your insurance plan.
  •  

  • Inquire if a prior authorization is needed from Florida Blue for Eliquis.

 

Gather Necessary Documentation

 

  • Prepare all necessary documentation including prescription details and any medical diagnoses that support the need for Eliquis.
  •  

  • Have your doctor's contact information ready in case Florida Blue needs to initiate communication for additional information.

 

Contact Florida Blue Customer Service

 

  • Call the customer service number on your Florida Blue insurance card to discuss your prescription coverage options.
  •  

  • Inquire about the pre-approval process if required, and ask for specific forms that need to be filled out for Eliquis coverage.

 

Submit a Prior Authorization Request

 

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

  • Ensure that all sections are thoroughly filled and all required documentation is attached to prevent delays.

 

Appeal if Denied

 

  • If your request for coverage is denied, review the reason for denial provided by Florida Blue.
  •  

  • Work with your doctor to gather additional supporting information and submit an appeal or grievance with Florida Blue.

 

Explore Additional Assistance Programs

 

  • Consider looking into patient assistance programs offered by the manufacturer of Eliquis, which might offer financial help if the insurance coverage is insufficient.
  •  

  • Contact Florida Blue to see if they offer any additional prescription assistance programs.

 

Review and Re-Evaluate Annually

 

  • Each year, during open enrollment, review your Florida Blue plan and formulary to ensure that Eliquis coverage remains consistent.
  •  

  • Make adjustments as necessary, considering any changes in your healthcare needs.

 

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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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