Does MDwise Cover Eliquis

Explore why MDwise might deny Eliquis coverage, learn how to secure coverage, discover costs without insurance, and find answers in our detailed FAQ.
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Coverage for Eliquis by MDwise

 

  • MDwise covers Eliquis under its health plans, but coverage may vary depending on specific plan policies.
  •  

  • Eliquis is typically covered for treatment of certain medical conditions such as deep vein thrombosis (DVT), pulmonary embolism (PE), and for stroke prevention in individuals with nonvalvular atrial fibrillation (AFib).

 

Criteria for Coverage

 

  • Patients often need a prescription from a healthcare provider to qualify for coverage.
  •  

  • Approval may require prior authorization, where the healthcare provider must demonstrate medical necessity.
  •  

  • Coverage might be influenced by trying alternative, less expensive medications first, following the plan's step therapy protocols.

 

Basic Rules

 

  • Members should check their specific MDwise plan for details, as formularies can change and impact drug availability.
  •  

  • It is advisable to contact MDwise customer service for the most up-to-date information on drug coverage.

 

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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.

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 MDwise

 

Getting Started with MDwise

 

  • Visit the MDwise website or contact their customer service to understand their plan options. You can typically find resources tailored to prescription drug coverage, including medications like Eliquis.
  •  

  • Become familiar with the MDwise formulary, which is a list of medications covered by their plan. Confirm if Eliquis is included and identify any related requirements or restrictions.

 

Enroll in a MDwise Plan

 

  • Choose a health coverage plan from MDwise that best suits your needs. Consider factors such as premium costs, drug formulation, out-of-pocket expenses, and any network restrictions.
  •  

  • Complete the enrollment process, which may involve filling out forms, providing personal information, and selecting a prescription drug plan that includes Eliquis coverage.

 

Understand Your Coverage

 

  • Review the details of your selected plan to understand the extent of Eliquis coverage, including co-pays, deductibles, and any prior authorization requirements.
  •  

  • If requirements such as prior authorization are needed, ensure you or your healthcare provider submits the necessary paperwork promptly to avoid delays in getting your medication.

 

Get Prescription from Your Doctor

 

  • Schedule an appointment with your healthcare provider to discuss your need for Eliquis. Obtain a prescription that you can submit to your pharmacist.
  •  

  • Ensure that your healthcare provider is aware of your insurance coverage specifics, so they can assist with any necessary paperwork for coverage approval.

 

Fill Your Prescription

 

  • Take your prescription to a pharmacy that is within the MDwise network to ensure you receive the covered benefits.
  •  

  • Present your MDwise insurance card when filling the prescription to confirm coverage and amount of co-pay required, if applicable.
  •  

  • If there are any issues with the pharmacy regarding your coverage, contact MDwise customer support for assistance in resolving these problems.

 

Re-evaluate Your Plan Annually

 

  • At least once a year, review your MDwise coverage during the open enrollment period. Ensure that Eliquis is still covered under your plan for the upcoming year and consider any price changes or formulary updates.
  •  

  • Update your plan selection if necessary to maintain appropriate coverage for Eliquis or adjust based on any changes in your healthcare needs.

 

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FAQs

Does MDwise Cover Eliquis

Explore why MDwise might deny Eliquis coverage, learn how to secure coverage, discover costs without insurance, and find answers in our detailed FAQ.
Curex allergy drops unboxing

Is Eliquis Covered by MDwise

 

Coverage for Eliquis by MDwise

 

  • MDwise covers Eliquis under its health plans, but coverage may vary depending on specific plan policies.
  •  

  • Eliquis is typically covered for treatment of certain medical conditions such as deep vein thrombosis (DVT), pulmonary embolism (PE), and for stroke prevention in individuals with nonvalvular atrial fibrillation (AFib).

 

Criteria for Coverage

 

  • Patients often need a prescription from a healthcare provider to qualify for coverage.
  •  

  • Approval may require prior authorization, where the healthcare provider must demonstrate medical necessity.
  •  

  • Coverage might be influenced by trying alternative, less expensive medications first, following the plan's step therapy protocols.

 

Basic Rules

 

  • Members should check their specific MDwise plan for details, as formularies can change and impact drug availability.
  •  

  • It is advisable to contact MDwise customer service for the most up-to-date information on drug coverage.

 

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MDwise's Approved Criteria for Eliquis Coverage

 

MDwise Coverage Criteria for Eliquis

 

  • The prescription must be for an FDA-approved indication, which includes the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation.
  •  

  • Patients must have a documented diagnosis of deep vein thrombosis (DVT) or pulmonary embolism (PE), and Eliquis must be prescribed for treatment or risk reduction of recurrent DVT or PE following initial therapy.
  •  

  • For patients undergoing knee or hip replacement surgery, Eliquis is approved for the prophylaxis of DVT, which may lead to PE.
  •  

  • The prescription must be written by a healthcare provider from a recognized medical institution or a physician affiliated with a registered healthcare system.
  •  

  • Patients must have a documented contraindication or lack of efficacy to warfarin, or an explanation for the preference of Eliquis over warfarin in the medical records.
  •  

  • Eliquis therapy must be consistent with current standard of care, including proper dosing and duration, as guided by clinical practice guidelines or literature.
  •  

  • The patient should demonstrate adherence to previous anticoagulant therapy if applicable, documented by pharmacy refill history or physician notes.

 

Why MDwise Might Deny Eliquis Coverage

 

Reasons MDwise Might Deny Eliquis Coverage

 

  • **Non-Formulary Drug:** Eliquis may not be included on the MDwise formulary, meaning it's not listed among the medications that are covered under their plans.
  •  

  • **Lack of Prior Authorization:** MDwise might require prior authorization for Eliquis, and if this authorization is not obtained before the prescription is filled, they may deny coverage.
  •  

  • **Non-Medical Necessity:** If MDwise determines that Eliquis is not medically necessary based on their criteria or the patient's medical history, they may choose not to cover it.
  •  

  • **Step Therapy Requirements:** MDwise might enforce step therapy protocols, where a patient must try and fail on one or more cheaper alternatives before Eliquis will be covered. If these steps are not followed, coverage could be denied.
  •  

  • **Off-Label Use:** If Eliquis is prescribed for a use not approved by the FDA, MDwise may deny coverage due to its off-label status.
  •  

  • **Exclusion Due to Other Health Policies:** There may be specific exclusion clauses within the patient's MDwise health policy that deny coverage of certain drugs like 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.

 

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 MDwise

 

Getting Started with MDwise

 

  • Visit the MDwise website or contact their customer service to understand their plan options. You can typically find resources tailored to prescription drug coverage, including medications like Eliquis.
  •  

  • Become familiar with the MDwise formulary, which is a list of medications covered by their plan. Confirm if Eliquis is included and identify any related requirements or restrictions.

 

Enroll in a MDwise Plan

 

  • Choose a health coverage plan from MDwise that best suits your needs. Consider factors such as premium costs, drug formulation, out-of-pocket expenses, and any network restrictions.
  •  

  • Complete the enrollment process, which may involve filling out forms, providing personal information, and selecting a prescription drug plan that includes Eliquis coverage.

 

Understand Your Coverage

 

  • Review the details of your selected plan to understand the extent of Eliquis coverage, including co-pays, deductibles, and any prior authorization requirements.
  •  

  • If requirements such as prior authorization are needed, ensure you or your healthcare provider submits the necessary paperwork promptly to avoid delays in getting your medication.

 

Get Prescription from Your Doctor

 

  • Schedule an appointment with your healthcare provider to discuss your need for Eliquis. Obtain a prescription that you can submit to your pharmacist.
  •  

  • Ensure that your healthcare provider is aware of your insurance coverage specifics, so they can assist with any necessary paperwork for coverage approval.

 

Fill Your Prescription

 

  • Take your prescription to a pharmacy that is within the MDwise network to ensure you receive the covered benefits.
  •  

  • Present your MDwise insurance card when filling the prescription to confirm coverage and amount of co-pay required, if applicable.
  •  

  • If there are any issues with the pharmacy regarding your coverage, contact MDwise customer support for assistance in resolving these problems.

 

Re-evaluate Your Plan Annually

 

  • At least once a year, review your MDwise coverage during the open enrollment period. Ensure that Eliquis is still covered under your plan for the upcoming year and consider any price changes or formulary updates.
  •  

  • Update your plan selection if necessary to maintain appropriate coverage for Eliquis or adjust based on any changes in your healthcare needs.

 

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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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