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Does Kaiser Permanente Cover Eliquis

Discover reasons Kaiser might deny Eliquis, ways to secure coverage, and the cost without insurance. Get answers to FAQs on Eliquis with Kaiser Permanente.

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Kaiser Permanente Coverage for Eliquis

Kaiser Permanente typically covers Eliquis as part of its formulary, if prescribed by a Kaiser-associated physician.

Coverage usually applies for conditions like atrial fibrillation, deep vein thrombosis (DVT), and pulmonary embolism, where Eliquis is deemed medically necessary.

Patients may need to meet certain criteria to qualify for coverage, such as prior authorization or failure of other medications.

The cost or copayment can vary based on your specific health plan and benefits package.

Check with a Kaiser Permanente representative to verify your plan’s specifics and coverage limitations for Eliquis.

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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.

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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 Kaiser Permanente

Verify Your Coverage

Log in to your Kaiser Permanente account through their official website or mobile app to check your current health plan details.

Review your plan's formulary, which is a list of medications covered under your prescription drug benefit. Look for Eliquis specifically.

If Eliquis isn't listed, consider other plan options or consult with a Kaiser Permanente representative.

Consult with Your Doctor

Schedule an appointment with your Kaiser Permanente healthcare provider to discuss your need for Eliquis.

Your doctor can provide necessary medical justification for the prescription if Eliquis is not typically covered under your current plan.

Discuss any alternatives if cost is a major concern, or if there are generic versions that could provide similar benefits.

Request Prior Authorization

If Eliquis requires prior authorization, your healthcare provider will need to submit a request to Kaiser Permanente on your behalf.

Make sure all necessary medical records and justifications are forwarded promptly to avoid delays.

Keep in touch with your doctor's office to ensure that this process is moving forward and to address any additional requirements.

Explore Financial Assistance

If coverage is denied or is only partial, inquire about any financial assistance programs Kaiser Permanente might offer for medications like Eliquis.

Contact the manufacturer of Eliquis directly, as they often have support programs for patients in need.

Check independent foundations or nonprofits that provide medication assistance to determine if you're eligible for aid.

Consider Appeal Options

If your request for Eliquis coverage is denied despite efforts, ask Kaiser Permanente about their appeals process.

Gather any additional supporting documents or letters from healthcare providers that could strengthen your case.

Submit your appeal within the prescribed timeframe, ensuring all formal paperwork is complete and accurate.

Stay Informed

Regularly check notifications from Kaiser Permanente for any changes in your plan coverage, which might affect Eliquis availability.

Attend informational sessions or webinars offered by Kaiser Permanente to better understand your benefits.

Maintain communication with your healthcare provider regarding any changes in your treatment plan that might affect prescription needs.

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FAQs

Does Kaiser Permanente Cover Eliquis

Discover reasons Kaiser might deny Eliquis, ways to secure coverage, and the cost without insurance. Get answers to FAQs on Eliquis with Kaiser Permanente.

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Is Eliquis Covered by Kaiser Permanente

Kaiser Permanente Coverage for Eliquis

Kaiser Permanente typically covers Eliquis as part of its formulary, if prescribed by a Kaiser-associated physician.

Coverage usually applies for conditions like atrial fibrillation, deep vein thrombosis (DVT), and pulmonary embolism, where Eliquis is deemed medically necessary.

Patients may need to meet certain criteria to qualify for coverage, such as prior authorization or failure of other medications.

The cost or copayment can vary based on your specific health plan and benefits package.

Check with a Kaiser Permanente representative to verify your plan’s specifics and coverage limitations for Eliquis.

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Kaiser Permanente's Approved Criteria for Eliquis Coverage

Criteria for Eliquis Coverage by Kaiser Permanente

Patients with a diagnosis of atrial fibrillation (AF) requiring anticoagulation therapy to reduce the risk of stroke and systemic embolism.

Individuals diagnosed with deep vein thrombosis (DVT) or pulmonary embolism (PE), requiring anticoagulation therapy for treatment and risk reduction of recurrence.

Those undergoing hip or knee replacement surgery needing anticoagulation therapy for preventing post-surgical DVT and PE.

Patients with renal impairment may be eligible for coverage, provided that kidney function aligns with manufacturer guidelines approved in clinical practices.

Individuals who have demonstrated an intolerance or contraindication to other anticoagulants, such as warfarin, or who have had challenges achieving effective therapeutic INR levels.

Possible consideration for individuals participating in clinical scenarios where they are unable to use other oral anticoagulation therapies due to interactions, allergies, or side effects, based on clinician evaluation.

Why Kaiser Permanente Might Deny Eliquis Coverage

Reasons for Eliquis Coverage Denial by Kaiser Permanente

**Non-Formulary Status**: Eliquis may be categorized as a non-formulary drug, meaning it is not included in Kaiser Permanente's list of approved medications for certain conditions.

**Alternative Medications Available**: If lower-cost or generic alternatives are available and deemed effective, Kaiser Permanente may deny coverage of Eliquis.

**Off-Label Use**: Kaiser Permanente might deny coverage if Eliquis is prescribed for a condition not approved by the US FDA or not supported by recognized clinical guidelines.

**Lack of Medical Necessity**: If it's determined that Eliquis is not medically necessary for an individual's specific condition or if the documentation provided does not justify its necessity, coverage might be denied.

**Prior Authorization Denied**: Depending on the plan, Eliquis may require prior authorization. Lack of approval during this process can result in coverage denial.

**Failure to Meet Specific Criteria**: Coverage could be denied if the patient does not meet specific clinical criteria established by Kaiser Permanente for using Eliquis, such as particular test results or previous treatment failure.

**Plan-Specific Restrictions**: Depending on the specific health plan, there might be unique restrictions or limitations that lead to denied coverage for Eliquis.

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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

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

Kayla Mardaga, NP

How to Get Eliquis Coverage with Kaiser Permanente

Verify Your Coverage

Log in to your Kaiser Permanente account through their official website or mobile app to check your current health plan details.

Review your plan's formulary, which is a list of medications covered under your prescription drug benefit. Look for Eliquis specifically.

If Eliquis isn't listed, consider other plan options or consult with a Kaiser Permanente representative.

Consult with Your Doctor

Schedule an appointment with your Kaiser Permanente healthcare provider to discuss your need for Eliquis.

Your doctor can provide necessary medical justification for the prescription if Eliquis is not typically covered under your current plan.

Discuss any alternatives if cost is a major concern, or if there are generic versions that could provide similar benefits.

Request Prior Authorization

If Eliquis requires prior authorization, your healthcare provider will need to submit a request to Kaiser Permanente on your behalf.

Make sure all necessary medical records and justifications are forwarded promptly to avoid delays.

Keep in touch with your doctor's office to ensure that this process is moving forward and to address any additional requirements.

Explore Financial Assistance

If coverage is denied or is only partial, inquire about any financial assistance programs Kaiser Permanente might offer for medications like Eliquis.

Contact the manufacturer of Eliquis directly, as they often have support programs for patients in need.

Check independent foundations or nonprofits that provide medication assistance to determine if you're eligible for aid.

Consider Appeal Options

If your request for Eliquis coverage is denied despite efforts, ask Kaiser Permanente about their appeals process.

Gather any additional supporting documents or letters from healthcare providers that could strengthen your case.

Submit your appeal within the prescribed timeframe, ensuring all formal paperwork is complete and accurate.

Stay Informed

Regularly check notifications from Kaiser Permanente for any changes in your plan coverage, which might affect Eliquis availability.

Attend informational sessions or webinars offered by Kaiser Permanente to better understand your benefits.

Maintain communication with your healthcare provider regarding any changes in your treatment plan that might affect prescription 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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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.

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

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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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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. 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?

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.

Can you prescribe Ozempic®* or Wegovy®*?

Our providers focus on personalized medications and dosages that aren’t commercially available at your local pharmacy. We don’t prescribe Ozempic®* or Wegovy®.* We may prescribe treatments containing compounded semaglutide or tirzepatide. 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.

Does Kaiser Permanente Cover Eliquis

Discover reasons Kaiser might deny Eliquis, ways to secure coverage, and the cost without insurance. Get answers to FAQs on Eliquis with Kaiser Permanente.

Achieve Your Goals Faster with Curex