{"id":633050,"date":"2025-08-05T18:01:08","date_gmt":"2025-08-05T22:01:08","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=633050"},"modified":"2025-08-05T18:01:08","modified_gmt":"2025-08-05T22:01:08","slug":"does-blue-cross-blue-shield-cover-eliquis","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-blue-cross-blue-shield-cover-eliquis\/","title":{"rendered":"Does Blue Cross Blue Shield cover Eliquis?"},"content":{"rendered":"

Eliquis<\/span><\/a> is a name-brand prescription medication that\u2019s 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 <\/span>Factor Xa inhibitor<\/span><\/a>, Eliquis works by thinning the blood to reduce the formation of blood clots, which can clog arteries and veins. There\u2019s no generic version of this <\/span>anticoagulant<\/span><\/a>, 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.\u00a0\u00a0<\/span><\/p>\n

Does Blue Cross Blue Shield cover Eliquis?<\/span><\/h2>\n

We checked over 20 <\/span>formularies<\/span><\/a> and found that Blue Cross Blue Shield (BCBS) typically covers Eliquis in its commercial, federal employee, Medicare, and Medicaid plans.\u00a0<\/span><\/p>\n

All of the BCBS formularies we looked at cover at least one <\/span>dosage of Eliquis<\/span><\/a> (<\/span>starter pack<\/span><\/a>, 2.5 mg, or 5 mg). It\u2019s 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.\u00a0<\/span><\/p>\n

Eliquis usually doesn\u2019t require <\/span>prior authorization<\/span><\/a> or <\/span>step therapy<\/span><\/a>, so you can get the prescription without the insurance company\u2019s formal pre-approval process and without having to try other prescription medications first. However, most formularies impose <\/span>quantity limits<\/span><\/a> (QL) on Eliquis, meaning Blue Cross Blue Shield will only cover a certain number of tablets every 30, 60, or 90 days.\u00a0<\/span><\/p>\n

You may also see the abbreviation \u201cMT\u201d on some formularies, which stands for \u201cMaintenance.\u201d It means a 90-day supply of Eliquis must be prescribed.<\/span><\/p>\n

\u201cIn general, Eliquis is a widely prescribed anticoagulant and is often covered for common uses, such as atrial fibrillation, deep vein thrombosis, or pulmonary embolism,\u201d says <\/span>Edmond Hakimi<\/span><\/a>, a dual-board-certified internal medicine physician and the medical director at Wellbridge. \u201cBut coverage can vary based on state, employer, and the exact formulary your plan follows.\u201d<\/span><\/p>\n

How much does Eliquis cost without insurance?<\/span><\/h2>\n

Without insurance, Eliquis costs<\/span><\/a> 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.\u00a0<\/span><\/p>\n

How much does Eliquis cost with Blue Cross Blue Shield?<\/span><\/h2>\n

Prescription drug prices vary by plan, so it\u2019s 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:<\/span><\/p>\n