Are you struggling with the high cost of Eliquis on your Medicare plan? You’re not alone.
Many seniors face this challenge, but there are several ways to reduce those expenses without compromising your health.
Medicare patients pay an average of $54 per month for Eliquis, but 5 out of 10 patients pay $40 or less thanks to available savings options. Using manufacturer coupons, assistance programs, and Medicare Extra Help can dramatically lower your costs.
Some patients even qualify for free medication through financial assistance programs.
Looking for immediate savings? SingleCare coupons might help, or you could ask your doctor if a generic alternative would work for your situation.
Many readers combine multiple strategies to make this vital medication more affordable. Medicare’s Low-Income Subsidy program is another lifeline worth exploring if you’re on a tight budget.
Understanding Eliquis Costs With Medicare
Medicare coverage for Eliquis can be confusing, but knowing the basics helps save money.
Most Medicare patients pay between $40-$54 per month for this blood thinner, though costs vary widely depending on your specific plan and coverage phase.
How Medicare Covers Eliquis
Medicare Part D is the prescription drug coverage that helps pay for medications like Eliquis.
These plans are offered by private insurance companies that follow Medicare’s rules. Each Part D plan has its own formulary (list of covered drugs).
Eliquis is typically included in most Medicare prescription drug plans. It’s often placed in higher tiers, which means higher costs for you.
Some plans place it in Tier 3 (preferred brand-name drugs), while others might stick it in Tier 4 (non-preferred drugs).
The coverage phase you’re in also affects what you’ll pay. During the deductible phase, you might pay full price.
In the initial coverage phase, you’ll pay your plan’s copay or coinsurance.
Typical Out-Of-Pocket Expenses
According to the manufacturer, Medicare patients pay about $54 per month for Eliquis on average. About half of Medicare patients pay $40 or less.
Your specific costs depend on:
- Your plan’s deductible (ranges from $0-$545 in 2023)
- Your plan’s copay or coinsurance for Eliquis
- Which coverage phase you’re in (deductible, initial coverage, coverage gap, or catastrophic)
During the coverage gap (donut hole), you’ll pay 25% of the cost. Once you reach catastrophic coverage, your costs drop significantly—either 5% of the drug cost or a small copay, whichever is higher.
Why Drug Costs Vary Between Plans
There are huge differences in Eliquis pricing between Medicare plans because each prescription drug plan negotiates separately with pharmaceutical companies.
Some factors causing these variations:
- Formulary placement—plans can put Eliquis in different tiers
- Pharmacy networks—using preferred pharmacies can save you money
- Plan design—some have higher premiums but lower drug costs
- Prior authorization requirements—some plans require extra steps before covering Eliquis
Your location matters too. Medicare plans have different pricing structures in different regions, which is why your friend in Florida might pay a different amount than you do in Michigan.
Smart shoppers compare several Medicare plans during open enrollment to find the best Eliquis coverage. The Plan Finder tool on Medicare.gov lets you search plans that include your medications.
Choosing The Right Medicare Coverage For Lower Eliquis Costs
Navigating Medicare options can feel like solving a puzzle, but picking the right coverage could save you serious money on Eliquis.
The difference between paying $40 or $784 per month often comes down to understanding a few key aspects of your Medicare coverage.
Comparing Medicare Prescription Drug Plans
Not all Medicare prescription drug plans are created equal when it comes to Eliquis coverage.
Medicare Part D plans vary in how they cover this blood thinner. Monthly premiums for these plans typically range from $15 to $100+, but cheaper isn’t always better.
When shopping for a plan, don’t just look at the premium. Check these crucial details:
- Annual deductible (ranges from $0-$505 in 2025)
- Copay or coinsurance amounts specifically for Eliquis
- Coverage gap provisions (the “donut hole”)
Many Medicare patients have saved hundreds by switching to a plan with slightly higher premiums but much lower Eliquis costs.
Use Medicare’s Plan Finder tool during open enrollment (Oct 15-Dec 7) to compare your options side-by-side.
How Formularies Impact Coverage
A formulary—your plan’s “approved drug list”—makes a massive difference in what you’ll pay for Eliquis.
Formularies organize medications into tiers:
- Tier 1: Usually generic drugs (lowest cost)
- Tier 2: Preferred brand-name drugs
- Tier 3: Non-preferred brand-name drugs
- Tier 4+: Specialty drugs (highest cost)
Eliquis might be a Tier 2 drug on one plan (maybe $40/month) and Tier 3 on another (possibly $100+/month).
Some plans offer “preferred pharmacies” where you’ll pay less for the same medication.
Don’t be shy about calling plans directly to ask specifically about Eliquis coverage. Their customer service can tell you exactly which tier it falls into and estimate your costs.
Using Medicare Advantage Plans
Medicare Advantage plans (Part C) bundle your hospital, medical, and often prescription coverage into one package with potentially lower out-of-pocket costs.
Some advantages include:
- Built-in prescription coverage (no separate Part D needed)
- Lower copays at in-network pharmacies
- Additional cost-saving programs not available with Original Medicare
Many people pay just $20-$40 monthly for Eliquis through well-chosen Medicare Advantage plans. You’ll typically need to use network providers and pharmacies.
The best Medicare Advantage plans for Eliquis users often have higher overall ratings (look for those 4-5 star plans!) and specific benefits for chronic conditions.
Check if your plan offers medication therapy management services—these pharmacist consultations can identify additional savings opportunities.
Financial Assistance And Extra Help Programs
Medicare offers several programs that can slash your Eliquis costs. Let’s explore how you might qualify for these money-saving opportunities and where to find additional help.
Qualifying For Extra Help
Extra Help (Low-Income Subsidy or LIS) is Medicare’s program to reduce high prescription costs.
To qualify, your resources must be limited to $16,660 for individuals or $33,240 for married couples living together.
Income limits apply too, generally below 150% of the Federal Poverty Level. With Extra Help, your Eliquis might cost as little as $4.15 per prescription.
The application process is straightforward. You can apply online at Social Security’s website, call them at 1-800-772-1213, or visit your local Social Security office.
Medicaid And SSI Benefits
If you receive Supplemental Security Income (SSI) benefits, you’re automatically enrolled in Extra Help.
For dual-eligible people (those with both Medicare and Medicaid), prescription coverage is even better. You’ll typically pay no more than $4.15 for each Eliquis prescription in 2025.
Medicaid qualification varies by state, but it’s worth checking if your income falls below 138% of the Federal Poverty Level.
Some states have even higher thresholds.
Even if you don’t fully qualify for Medicaid, partial benefits might be available through Medicare Savings Programs. These can help with premiums and sometimes medication costs too.
Pharmaceutical Assistance And AARP Resources
The Bristol Myers Squibb Patient Assistance Foundation offers free Eliquis for qualified patients.
Their income requirements are more generous than you might expect—up to 500% of the Federal Poverty Level in some cases.
AARP’s prescription discount program can save you up to 61% on medications like Eliquis. While not specifically for Medicare members, these discounts can sometimes beat your Medicare copay.
Other helpful resources include:
- RxHope.com
- NeedyMeds.org
- Medicare Rights Center (1-800-333-4114)
Check with your state’s pharmaceutical assistance program. Many states offer extra help beyond Medicare’s programs, with Pennsylvania, New York, and Illinois having particularly robust options.
Managing High Eliquis Costs Throughout The Year
Keeping your Eliquis affordable throughout the year can be tricky as Medicare costs shift.
Understanding how coverage phases work and tracking your spending can save you hundreds of dollars.
Part D Coverage Gap And Catastrophic Coverage
Medicare Part D has different phases that affect what you pay for Eliquis. The “donut hole” (coverage gap) kicks in after you and your plan spend a certain amount on drugs.
In 2025, this happens after about $4,660 in total drug costs. During this gap, you’ll pay 25% of your Eliquis costs.
Once your out-of-pocket costs reach $7,400, you enter catastrophic coverage. At this point, you’ll typically pay only 5% of the cost.
The 2022 Prescription Drug Law is gradually eliminating the catastrophic phase. By 2024, your out-of-pocket costs will be capped at $2,000 annually.
Tracking Prescription Spending
Track every penny you spend on prescriptions.
Your Medicare Part D plan provides monthly statements, but actually read them.
Create a simple spreadsheet or use an app to monitor:
- What you’ve paid for Eliquis each month
- Total out-of-pocket costs
- Where you stand in the coverage phases
Ask your pharmacist for a year-to-date spending report. This document shows exactly how close you are to reaching the coverage gap or catastrophic phase.
Timing refills strategically can sometimes save money too.
Many Medicare plans offer online portals or apps where you can check your drug spending in real-time. These tools are helpful for planning your healthcare budget throughout the year.
Tips And Strategies For Saving On Eliquis
Navigating Medicare prescription drug coverage can be tricky, especially for pricier medications like Eliquis.
Here are several practical ways to reduce your out-of-pocket costs while still getting this important medication.
Switching To A Preferred Pharmacy
Your Medicare prescription drug plan likely has “preferred pharmacies” where you’ll pay less.
These arrangements can save you money on each refill. Copays can drop by $10-15 per month just by switching where you fill your prescription.
Mail-order pharmacies are another option. Many Medicare prescription drug plans offer discounts when you order a 90-day supply through their mail service.
This approach can slash your costs and save you trips to the pharmacy.
Compare prices at different pharmacies. Even with the same prescription drug coverage, prices can vary between Walgreens, CVS, or your local grocery store pharmacy.
Exploring Generic And Therapeutic Alternatives
While Eliquis (apixaban) doesn’t have a generic version yet in the US, there are other options worth discussing with your doctor.
Some prescription drug plans might cover similar blood thinners like warfarin at a much lower cost tier.
Ask your doctor about therapeutic alternatives that might work for your condition. Sometimes an older medication might be just as effective for your specific situation at a fraction of the price.
Before switching, talk with your healthcare provider. They can explain the pros and cons of each alternative and help determine if it’s appropriate for your health needs.
Some Medicare prescription drug plans have special exceptions processes. If alternatives won’t work for you, your doctor might be able to request coverage for Eliquis at a lower cost tier.
Reviewing Additional Medicare Benefits And Coverage Options
Medicare offers various coverage options that can help lower your Eliquis costs.
Understanding these different benefits and how they work together can save you hundreds of dollars each month.
Understanding Medicare Parts A and B
Original Medicare consists of Part A (hospital insurance) and Part B (medical insurance).
While these parts don’t typically cover prescription drugs like Eliquis, they’re the foundation of your Medicare coverage.
Part A covers inpatient hospital stays, skilled nursing facility care, and some home health services.
Most people don’t pay a premium for Part A if they’ve worked long enough.
Part B covers doctor visits, outpatient care, and some preventive services. The standard Part B premium in 2025 is around $170 per month, though this can vary based on your income.
Neither Part A nor B directly covers Eliquis, but they’re important because they allow you to qualify for prescription drug coverage through Part D or Medicare Advantage plans.
Stacking Benefits From Different Medicare Plans
We’ve found that combining different Medicare plans can maximize your savings on medications like Eliquis.
For example, having Original Medicare with a standalone Part D plan gives you flexibility in choosing prescription coverage.
Medicare Advantage (Part C) plans often bundle extra benefits along with Parts A and B coverage.
Many include prescription drug coverage and additional perks like dental or vision care.
According to our research, about 5 out of 10 ELIQUIS patients on Medicare pay $25 or less per month.
The “Extra Help” program is another fantastic option!
This Medicare program assists people with limited income and resources to pay for prescription medications.
If you qualify, you might pay significantly reduced costs for Eliquis—sometimes as little as a few dollars per prescription.
Don’t forget to compare plans during Open Enrollment (October 15-December 7)!
Different plans cover Eliquis at different tiers, affecting your out-of-pocket costs.