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Does Humana Cover Eliquis

Find out if Humana covers Eliquis, reasons for denial, tips for obtaining coverage, costs without insurance, and frequently asked questions.
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Does Humana Cover Eliquis?

 

  • Humana's coverage for Eliquis can vary based on the specific plan (PPO, HMO, Medicare Advantage, etc.) you are enrolled in. It's important to verify with Humana directly or through your plan documents.

    •  

  • Eliquis is often covered under Part D prescription drug plans, but the level of coverage may depend on whether it is considered a preferred or non-preferred brand.

    •  

  • Check if Eliquis requires prior authorization or if it's subject to step therapy, where other medications must be tried first.

    •  

  • Your out-of-pocket expenses (copayments or coinsurance) will depend on the tier placement of Eliquis in your plan's formulary.

    •  

  • Check with your healthcare provider and Humana to ensure that your prescription meets the criteria and guidelines specified in your plan.

    •  

  • Always analyze your annual notice of change to see if there are any updates on how Eliquis is covered in your plan.

 

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Clinical Support

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 Humana

 

Verify Your Medicare Plan with Humana

 

  • Contact Humana directly to confirm that your current Medicare plan includes prescription drug coverage, as Eliquis is typically covered under Medicare Part D policies.
  • Review the Summary of Benefits document provided by Humana to verify that Eliquis is included in the list of covered medications.

 

Consult the Humana Formulary

 

  • Access Humana's online formulary to determine the tier level and coverage details specific to Eliquis.
  • Find out if there are any prior authorization requirements or step therapy procedures you need to follow for Eliquis.

 

Contact Humana Customer Service

 

  • Reach out to Humana's customer service for personalized assistance on getting Eliquis covered, especially if it involves navigating complex plan details.
  • Inquire if there are any special programs, discounts, or patient assistant services offered for Eliquis.

 

Consult Your Healthcare Provider

 

  • Discuss your prescription needs with your doctor or healthcare provider. They may need to provide documentation or justification for Eliquis coverage.
  • Ask your healthcare provider if there's a need to fill out a Prior Authorization form to ensure your Humana plan can cover Eliquis.

 

Understand the Cost Structure

 

  • Check for your plan’s co-pay, deductible, and out-of-pocket expenses associated with Eliquis.
  • Review the cost-sharing aspects by understanding how much Humana contributes versus what you have to pay.

 

Use Humana's Mail Order Pharmacy

 

  • If applicable, consider using Humana's mail order pharmacy service, which often provides medications at a lower cost and with convenient home delivery.
  • Explore whether the mail order pharmacy offers any greater discounts for Eliquis.

 

Reassess During Open Enrollment

 

  • If you are unsatisfied with the current coverage of Eliquis under Humana, consider re-evaluating your plan options during the Medicare open enrollment period.
  • Consult with a Humana representative to discuss potential plan changes that might better cover Eliquis.

 

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FAQs

Does Humana Cover Eliquis

Find out if Humana covers Eliquis, reasons for denial, tips for obtaining coverage, costs without insurance, and frequently asked questions.
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Is Eliquis Covered by Humana

 

Does Humana Cover Eliquis?

 

  • Humana's coverage for Eliquis can vary based on the specific plan (PPO, HMO, Medicare Advantage, etc.) you are enrolled in. It's important to verify with Humana directly or through your plan documents.

    •  

  • Eliquis is often covered under Part D prescription drug plans, but the level of coverage may depend on whether it is considered a preferred or non-preferred brand.

    •  

  • Check if Eliquis requires prior authorization or if it's subject to step therapy, where other medications must be tried first.

    •  

  • Your out-of-pocket expenses (copayments or coinsurance) will depend on the tier placement of Eliquis in your plan's formulary.

    •  

  • Check with your healthcare provider and Humana to ensure that your prescription meets the criteria and guidelines specified in your plan.

    •  

  • Always analyze your annual notice of change to see if there are any updates on how Eliquis is covered in your plan.

 

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Humana's Approved Criteria for Eliquis Coverage

 

Eligibility for Eliquis Coverage Under Humana

 

  • Patients must have a diagnosis of non-valvular atrial fibrillation (NVAF) with a medium to high risk of stroke and systemic embolism.

    •  

  • Eliquis can be covered for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), as well as for the reduction in the risk of recurrent DVT and PE.

    •  

  • Coverage may be extended to patients requiring prophylaxis for DVT following hip or knee replacement surgery.

 

Prescription Requirement

 

  • Prescription must be written by a healthcare provider licensed and qualified in the treatment of conditions that Eliquis addresses.

    •  

  • A prescription from a cardiologist, hematologist, or another relevant specialist might be necessary, depending on specific insurance plan stipulations.

 

Prior Authorization Criteria

 

  • A documented trial and failure or contraindication to other anticoagulant therapies may be required, such as warfarin, unless contraindicated or clinically inappropriate.

    •  

  • The patient’s medical records should substantiate the necessity for Eliquis, reflecting both the diagnosis and previous treatment history.

 

Coverage Based on Benefit Plan

 

  • Coverage for Eliquis might vary based on the specific Humana benefit plan, and members should consult their individual plan specifics for precise coverage details.

    •  

  • Plans may offer different tiers of coverage, affecting copay and coinsurance responsibilities by the patient.

 

Age and Dosage Considerations

 

  • Based on medical guidelines, dosage of Eliquis covered may be according to patient-specific factors such as age, renal function, and concurrent medications.

    •  

  • Verification of standard dosing as per the prescribing information may be required for approval and coverage.

 

Renewal of Coverage

 

  • Periodic renewal of authorization for Eliquis may require updated documentation, showing continued necessity and efficacy of the medication.

    •  

  • Regular follow-up consultations with the prescribing healthcare provider to assess treatment progress may be necessary for continued coverage.

 

Why Humana Might Deny Eliquis Coverage

 

Situations When Humana Might Deny Eliquis Coverage

 

  • Prescription does not follow the FDA-approved usage for Eliquis, such as off-label uses not recognized by Humana.

    •  

  • The patient does not meet the clinical criteria outlined by Humana, e.g., specific indications for atrial fibrillation, deep vein thrombosis, or pulmonary embolism.

    •  

  • Failure to attempt or follow recommended formulary alternatives, which could include generic or preferred anticoagulants that are covered.

    •  

  • Lack of adequate documentation from the prescribing healthcare provider supporting the medical necessity of Eliquis for the patient.

    •  

  • Eliquis is prescribed for a condition that is covered under a different medication tier requiring additional justification or prior authorization.

    •  

  • Denial due to quantity limits if the prescribed amount exceeds the maximum limit covered by Humana’s policy without proper justification.

    •  

  • Non-compliance with Humana's step therapy policy, where the patient is required to try and fail other medications first.

    •  

  • Any discrepancy in the patient’s insurance information or coverage scope that contradicts Humana's records or policy terms.

 

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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.

 

Clinical Support

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 Humana

 

Verify Your Medicare Plan with Humana

 

  • Contact Humana directly to confirm that your current Medicare plan includes prescription drug coverage, as Eliquis is typically covered under Medicare Part D policies.
  • Review the Summary of Benefits document provided by Humana to verify that Eliquis is included in the list of covered medications.

 

Consult the Humana Formulary

 

  • Access Humana's online formulary to determine the tier level and coverage details specific to Eliquis.
  • Find out if there are any prior authorization requirements or step therapy procedures you need to follow for Eliquis.

 

Contact Humana Customer Service

 

  • Reach out to Humana's customer service for personalized assistance on getting Eliquis covered, especially if it involves navigating complex plan details.
  • Inquire if there are any special programs, discounts, or patient assistant services offered for Eliquis.

 

Consult Your Healthcare Provider

 

  • Discuss your prescription needs with your doctor or healthcare provider. They may need to provide documentation or justification for Eliquis coverage.
  • Ask your healthcare provider if there's a need to fill out a Prior Authorization form to ensure your Humana plan can cover Eliquis.

 

Understand the Cost Structure

 

  • Check for your plan’s co-pay, deductible, and out-of-pocket expenses associated with Eliquis.
  • Review the cost-sharing aspects by understanding how much Humana contributes versus what you have to pay.

 

Use Humana's Mail Order Pharmacy

 

  • If applicable, consider using Humana's mail order pharmacy service, which often provides medications at a lower cost and with convenient home delivery.
  • Explore whether the mail order pharmacy offers any greater discounts for Eliquis.

 

Reassess During Open Enrollment

 

  • If you are unsatisfied with the current coverage of Eliquis under Humana, consider re-evaluating your plan options during the Medicare open enrollment period.
  • Consult with a Humana representative to discuss potential plan changes that might better cover Eliquis.

 

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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.

 

Have questions left?

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A weight management program tailored to you

Initial Dosage

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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Curex provides allergy care plans for allergies, asthma, eczema and pet allergies.

Curex providers may prescribe sublingual allergy drops that contain the same ingredients as allergy shots but are more convenient & affordable.
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