Does Scripps Health Cover Eliquis

Explore why Scripps Health might deny Eliquis coverage, ways to secure coverage, costs without insurance, and get answers to frequently asked questions.
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Does Scripps Health Cover Eliquis?

 

  • Scripps Health provides coverage for Eliquis as part of its prescription drug benefits. Coverage is typically subject to plan specifics, so individual plans may vary.
  •  

  • Situations where Eliquis is covered typically include its use as an anticoagulant for preventing stroke and blood clots, particularly in patients with non-valvular atrial fibrillation or those who've had knee or hip replacement surgery.
  •  

  • To get Eliquis covered, patients typically must satisfy prior authorization requirements. This often involves demonstrating medical necessity, aligning with plan guidelines for coverage.
  •  

  • Patients might be required to try and fail other medications first, or the prescribing doctor must confirm Eliquis is the most appropriate treatment.
  •  

  • For cost details and specific coverage conditions, policyholders should contact Scripps Health or refer to their individual plan documentation.

 

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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 Scripps Health

 

Start by Contacting Scripps Health

 

  • Reach out to Scripps Health Customer Service to inquire about prescription drug coverage. You can find contact information on their official website. It’s important to talk to a representative who can give you detailed information specific to your health plan.
  •  

  • Ask about coverage for Eliquis, specifically. Each health plan might have different coverage details, so it's crucial to verify this information specifically for Eliquis.

 

Review Your Health Insurance Plan

 

  • Log in to your Scripps Health online account to view your current health insurance plan details. Look for the section on prescription drug coverage to understand what medications are included under your current plan.
  •  

  • If you're unable to find specific details on Eliquis, consider downloading your plan's formulary (a list of covered medications) or contacting customer service for assistance.

 

Consult with Your Healthcare Provider

 

  • Speak with your healthcare provider about your need for Eliquis. They can provide you with important medical documentation or a prescription, which is often required for insurance processing.
  •  

  • Your healthcare provider might also be able to advise you on any prior authorization or step therapy requirements specific to your Scripps Health insurance plan.

 

Check for Prior Authorization Requirements

 

  • Confirm if prior authorization is required for Eliquis. This step is crucial as many health plans require approval before they agree to cover certain medications.
  •  

  • If prior authorization is needed, work with your healthcare provider to submit the necessary forms and documentation to Scripps Health.

 

Explore Financial Assistance Programs

 

  • If you encounter significant coverage gaps or costs for Eliquis, ask Scripps Health about any available financial assistance programs.
  •  

  • You can also directly check with the manufacturer of Eliquis for patient assistance programs which might help lower your medication costs.

 

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FAQs

Does Scripps Health Cover Eliquis

Explore why Scripps Health might deny Eliquis coverage, ways to secure coverage, costs without insurance, and get answers to frequently asked questions.
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Is Eliquis Covered by Scripps Health

 

Does Scripps Health Cover Eliquis?

 

  • Scripps Health provides coverage for Eliquis as part of its prescription drug benefits. Coverage is typically subject to plan specifics, so individual plans may vary.
  •  

  • Situations where Eliquis is covered typically include its use as an anticoagulant for preventing stroke and blood clots, particularly in patients with non-valvular atrial fibrillation or those who've had knee or hip replacement surgery.
  •  

  • To get Eliquis covered, patients typically must satisfy prior authorization requirements. This often involves demonstrating medical necessity, aligning with plan guidelines for coverage.
  •  

  • Patients might be required to try and fail other medications first, or the prescribing doctor must confirm Eliquis is the most appropriate treatment.
  •  

  • For cost details and specific coverage conditions, policyholders should contact Scripps Health or refer to their individual plan documentation.

 

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Scripps Health's Approved Criteria for Eliquis Coverage

 

Criteria for Eliquis Coverage by Scripps Health

 

  • The patient must have a documented diagnosis of non-valvular atrial fibrillation (NVAF) and is at risk for stroke or systemic embolism.
  •  

  • Patient should have a known case of deep vein thrombosis (DVT) or pulmonary embolism (PE) for primary treatment or for reducing the risk of recurrence.
  •  

  • Patient is undergoing hip or knee replacement surgery and requires prophylaxis of DVT, which may lead to PE.
  •  

  • In cases of intolerance or contraindications to warfarin or other traditional anticoagulants, Eliquis may be covered as part of an alternative treatment plan.
  •  

 

Dosage and Administration

 

  • The prescribed dosage must align with FDA-approved dosing instructions based on specific medical conditions.
  •  

  • Documentation must show that the patient and prescriber are on a monitored course of therapy, ensuring compliance and effectiveness of Eliquis.
  •  

 

Why Scripps Health Might Deny Eliquis Coverage

 

Situations Where Scripps Health Might Deny Eliquis Coverage

 

  • **Non-FDA Approved Uses:** Coverage might be denied if Eliquis is prescribed for a condition not approved by the FDA. Scripps Health may only cover medications for their approved uses unless there is strong clinical evidence supporting their off-label use.
  •  

  • **Lack of Medical Necessity:** If Eliquis is deemed not medically necessary, Scripps Health might refuse coverage. This could occur if alternative treatments are available and deemed more suitable or cost-effective for the patient's condition.
  •  

  • **Without Prior Authorization:** Scripps Health may deny coverage for Eliquis if the necessary prior authorization or pre-approval from the insurer has not been obtained. Prior authorization ensures the medication is appropriate and necessary for the patient's condition.
  •  

  • **Non-Compliance with Formulary Requirements:** Eliquis may not be covered if it does not align with the formulary requirements for preferred medications. Patients might be required to use the formulary’s preferred drugs first unless those are proven insufficient.
  •  

  • **Failure to Meet Step Therapy Protocols:** If a patient has not tried and failed the standard therapies before being prescribed Eliquis, coverage might be declined due to not following the plan's step therapy protocols.
  •  

  • **Excluded from Specific Plans:** Scripps Health might not cover Eliquis if it is specifically excluded from certain insurance plans or tiers. These exclusions are typically outlined in the patient's specific health plan documents.

 

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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 Scripps Health

 

Start by Contacting Scripps Health

 

  • Reach out to Scripps Health Customer Service to inquire about prescription drug coverage. You can find contact information on their official website. It’s important to talk to a representative who can give you detailed information specific to your health plan.
  •  

  • Ask about coverage for Eliquis, specifically. Each health plan might have different coverage details, so it's crucial to verify this information specifically for Eliquis.

 

Review Your Health Insurance Plan

 

  • Log in to your Scripps Health online account to view your current health insurance plan details. Look for the section on prescription drug coverage to understand what medications are included under your current plan.
  •  

  • If you're unable to find specific details on Eliquis, consider downloading your plan's formulary (a list of covered medications) or contacting customer service for assistance.

 

Consult with Your Healthcare Provider

 

  • Speak with your healthcare provider about your need for Eliquis. They can provide you with important medical documentation or a prescription, which is often required for insurance processing.
  •  

  • Your healthcare provider might also be able to advise you on any prior authorization or step therapy requirements specific to your Scripps Health insurance plan.

 

Check for Prior Authorization Requirements

 

  • Confirm if prior authorization is required for Eliquis. This step is crucial as many health plans require approval before they agree to cover certain medications.
  •  

  • If prior authorization is needed, work with your healthcare provider to submit the necessary forms and documentation to Scripps Health.

 

Explore Financial Assistance Programs

 

  • If you encounter significant coverage gaps or costs for Eliquis, ask Scripps Health about any available financial assistance programs.
  •  

  • You can also directly check with the manufacturer of Eliquis for patient assistance programs which might help lower your medication costs.

 

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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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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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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.

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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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