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Does Blue Cross Blue Shield cover Eliquis?

BCBS coverage for Eliquis varies by plan
By | Aug. 5, 2025 Medically reviewed by Chad Shaffer, MD
A health insurance card, a stethoscope, and medication: Does Blue Cross Blue Shield cover Eliquis?

Key takeaways

  • Blue Cross Blue Shield (BCBS) health plans tend to cover the blood thinner Eliquis, but coverage varies from plan to plan.

  • The cost of Eliquis with BCBS varies considerably, from about $0 to over $300 per 60, 5 mg tablets.

  • Your plan’s drug formulary will tell you whether Eliquis is covered, and the Summary of Benefits (SOB) document will explain your out-of-pocket costs.

In this article:

Eliquis is a name-brand prescription medication that’s approved by the Food and Drug Administration (FDA) to prevent stroke and embolism in people with a certain type of arrhythmia (irregular heartbeat) called atrial fibrillation (AFib) and to treat and prevent blood clots. Known as a Factor Xa inhibitor, Eliquis works by thinning the blood to reduce the formation of blood clots, which can clog arteries and veins. There’s no generic version of this anticoagulant, and a 30-day supply can cost hundreds of dollars without insurance. Fortunately, Eliquis is usually covered, but there are some important considerations when using insurance.  

Does Blue Cross Blue Shield cover Eliquis?

We checked over 20 formularies and found that Blue Cross Blue Shield (BCBS) typically covers Eliquis in its commercial, federal employee, Medicare, and Medicaid plans. 

All of the BCBS formularies we looked at cover at least one dosage of Eliquis (starter pack, 2.5 mg, or 5 mg). It’s usually labelled a Tier 2 or Tier 3 drug, and the copay and coinsurance increase for higher tiers. The specific copay amount or coinsurance percentage varies by plan. 

Eliquis usually doesn’t require prior authorization or step therapy, so you can get the prescription without the insurance company’s formal pre-approval process and without having to try other prescription medications first. However, most formularies impose quantity limits (QL) on Eliquis, meaning Blue Cross Blue Shield will only cover a certain number of tablets every 30, 60, or 90 days. 

You may also see the abbreviation “MT” on some formularies, which stands for “Maintenance.” It means a 90-day supply of Eliquis must be prescribed.

“In general, Eliquis is a widely prescribed anticoagulant and is often covered for common uses, such as atrial fibrillation, deep vein thrombosis, or pulmonary embolism,” says Edmond Hakimi, a dual-board-certified internal medicine physician and the medical director at Wellbridge. “But coverage can vary based on state, employer, and the exact formulary your plan follows.”

How much does Eliquis cost without insurance?

Without insurance, Eliquis costs an average of $807 per 60, 5 mg tablets. This blood thinner is usually taken twice per day, so this price covers a 30-day supply. Drug prices fluctuate and vary by pharmacy and location. 

How much does Eliquis cost with Blue Cross Blue Shield?

Prescription drug prices vary by plan, so it’s difficult to give an average cost of Eliquis with Blue Cross Blue Shield. That said, here are some sample plans that may help you get a ballpark estimate:

How to check whether your Blue Cross Blue Shield plan covers Eliquis 

An easy way to check whether your Blue Cross Blue Shield plan covers Eliquis is to call the customer support number on the back of your insurance card. A BCBS representative can look up your plan benefits and let you know whether Eliquis is covered and how much it will cost. 

You can also look at your insurance plan documents online by logging into your BCBS account. Look for the formulary or drug list. Sometimes health insurance companies have a formulary search bar where you can enter the name of a drug and quickly find out if it’s covered. If the list of drugs is only available as a PDF, use the Ctrl+F function to locate Eliquis in the document.

How to save on Eliquis

You don’t have to pay the full retail price for Eliquis if your BCBS plan doesn’t cover it. 

For example, a SingleCare prescription discount card could lower the price of 60, 5 mg Eliquis tablets from about $807 to $488, depending on your choice of pharmacy. Enter your ZIP code on the SingleCare website and compare Eliquis prices by pharmacy. Click “Get Free Coupon” to generate your unique coupon card. Print it, save it to your free SingleCare account, or email or text it to yourself for easy reference. When you pick up your prescription, show the pharmacist the card to get a discount.

Other ways to save money on Eliquis may include using the manufacturer’s discount card or applying for government programs like Medicare Extra Help. However, both options are only available to eligible individuals. Your healthcare provider may also be able to prescribe a more affordable Eliquis alternative based on your health history.

“Studies suggest that Eliquis tends to have a lower risk of significant bleeding, particularly gastrointestinal bleeding, compared to some other medications,” Dr. Hakimi says. “That is one reason doctors often prefer it. However, if cost is a significant barrier, we work with patients to find a safe and effective alternative that suits their situation.”

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