{"id":633323,"date":"2025-08-26T15:12:40","date_gmt":"2025-08-26T19:12:40","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=633323"},"modified":"2026-05-07T18:29:48","modified_gmt":"2026-05-07T22:29:48","slug":"is-eliquis-covered-by-aetna","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/is-eliquis-covered-by-aetna\/","title":{"rendered":"Does Aetna cover Eliquis?"},"content":{"rendered":"

Most Aetna plans cover <\/span>Eliquis<\/span><\/a>, although you may need prior authorization before your plan will pay for it. Besides Aetna, most health insurance plans, including Medicare Part D and some state Medicaid programs, typically cover it too. Eliquis is a brand-name <\/span>anticoagulant<\/span><\/a> approved for the prevention or treatment of <\/span>blood clots<\/span><\/a>, including <\/span>deep vein thrombosis (DVT)<\/span><\/a> and <\/span>pulmonary embolism (PE)<\/span><\/a>, as well as the prevention of strokes in people with atrial fibrillation. The name of the generic drug is the same as the medication\u2019s active ingredient: apixaban. However, a generic version is not currently available and may not be released until at least 2028.\u00a0<\/span><\/p>\n

\t\t

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Save up to 80% on Eliquis with SingleCare<\/p>\n\t\t\t

Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.<\/p>\n\t\t\t

\n\t\t\t\t
\n\t\t\t\t\tEliquis 5 mg (28 Tablets)\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t23666 - Hampton, VA\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t
\n\t\t\t\"Kroger\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t$155.92\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
\n\t\t\t
\n\t\t\t\"Harris\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t$155.92\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\tSee Eliquis prices at all pharmacies<\/a>\n\t\t<\/div>\n\n\t\t<\/span><\/p>\n

Does Aetna cover Eliquis?<\/span><\/h2>\n

Medication coverage varies by insurance policy and plan, with health insurance mostly regulated at the <\/span>state level<\/span><\/a>. As far as Aetna and their plans, at least some cover Eliquis. For example, the <\/span>2026 Advanced Control Plan<\/span><\/a> lists Eliquis as a covered medication in both the 2.5 mg and 5 mg tablet strengths.<\/span><\/p>\n

Aetna’s Medicare Part D plans usually cover Eliquis, though the tier and copay depend on the plan. Medicaid coverage varies by state, so it’s best to check with your plan if you’re on Aetna Medicaid.<\/span><\/p>\n

Prior authorization with the health insurance company is often needed. In short, they want to know the underlying diagnosis or reason for the treatment. “The criteria for a prior authorization for Eliquis usually is either treatment for DVT or pulmonary embolism,” says Dr. Deepak Khanna, DO, an internist and family medicine physician at UPenn and the founder of dandRX, an FDA-approved anti-dandruff shampoo. “Or especially in those patients who are recently postoperative, they usually require a 30- to 45-day Eliquis dose to prevent a DVT.”\u00a0<\/span><\/p>\n

If a patient has <\/span>DVT<\/span><\/a>, it’s usually confirmed with ultrasound imaging. A blood test called a D-dimer is sometimes used to help rule out clots in people at lower risk, and it usually doesn’t require any special preparation.<\/span><\/p>\n

Eliquis can prevent other conditions, too, he continues, such as a stroke in patients who have a history of multiple strokes. However, using it for this purpose in someone without atrial fibrillation would be an off-label use and may not be covered by insurance.<\/span><\/p>\n

How to get approved for Eliquis<\/span><\/h2>\n

Healthcare providers are responsible for obtaining patient approval. “Typically, when I am tasked to do a prior authorization \u2026 It involves me calling the prior authorization phone number,” Dr. Khanna says. “I explain to them the rationale for why the patient needs this medication and why no other medication would be beneficial for this patient.”<\/span><\/p>\n

That’s why healthcare providers are needed here: they affirm the medical necessity of an individual patient receiving Eliquis. “If Eliquis is indeed what this patient requires in order to treat their medical condition successfully, I usually go out of my way to make sure that the patient gets the dose,” Dr. Khanna continues.\u00a0<\/span><\/p>\n

Medical professionals are also helpful because they create different treatment plans when problems arise. For example: “If the patient requires an anticoagulation medication like Eliquis, but the prior authorization is denied, then I will look at alternatives like Coumadin,” Dr. Khanna says. Other options include blood thinners like Xarelto (rivaroxaban) or Pradaxa (dabigatran), depending on your condition and medical history.<\/span><\/p>\n

If you have additional questions or want more information or tips on getting approved for Eliquis, talk to a medical assistant or medical provider. They often deal with insurance approvals and can walk you through the process.<\/span><\/p>\n

How much does Eliquis cost?<\/span><\/h2>\n

Without insurance<\/span><\/a>, Eliquis typically costs an average of $384 for 28, 5 mg tablets. Although insurance may help cover the cost of Eliquis, you’ll usually still have a copay. The <\/span>average copay varies<\/span><\/a>, but is about $39 per month with a manufacturer savings card or even as low as $10 per month when it’s prescribed for a DVT or PE.<\/span><\/p>\n

How to check whether your Aetna plan covers Eliquis\u00a0<\/span><\/h2>\n

Checking which prescription drugs your Aetna plan covers is quick and straightforward. You can use Aetna’s website and complete the following steps:<\/span><\/p>\n

    \n
  1. Go to <\/span>Aetna\u2019s prescription drug list page<\/span><\/a>.<\/span><\/li>\n
  2. Select your plan year and plan name using the dropdown boxes.<\/span><\/li>\n
  3. Click the link that pops up below.<\/span><\/li>\n
  4. Click the “Find medicine” button.<\/span><\/li>\n
  5. Type \u201cEliquis\u201d in the \u201cBrand and Generic Name Search\u201d box and click \u201cSearch.\u201d<\/span><\/li>\n
  6. See what comes up.<\/span><\/li>\n<\/ol>\n

    How to save on Eliquis<\/span><\/h2>\n

    For people without insurance who need help covering the cost of Eliquis, SingleCare offers <\/span>prescription discount cards<\/span><\/a>, including an <\/span>Eliquis coupon<\/span><\/a> and coupons for other medications. All you need to do is click \u201cGet free coupon\u201d under the store you plan to get the medication from, and then show the virtual card to the pharmacist.\u00a0<\/span><\/p>\n

    Patients may also be able to <\/span>save on Eliquis<\/span><\/a> by signing up for mail-order prescriptions or government assistance programs. Visit the manufacturer\u2019s website to see if it offers savings options, such as coupon cards or other programs. You can also ask your healthcare provider about alternatives or about changing your health insurance plan. Those who have already picked up their Eliquis prescription at their local pharmacy can consider these options next time.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

    Most Aetna plans cover Eliquis, although you may need prior authorization before your plan will pay for it. Besides Aetna, most health insurance plans, including Medicare Part D and some state Medicaid programs, typically cover it too. Eliquis is a brand-name anticoagulant approved for the prevention or treatment of blood clots, including deep vein thrombosis […]<\/p>\n","protected":false},"author":85,"featured_media":633324,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[15103,608,4350],"coauthors":[21001],"class_list":["post-633323","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-drug-pricing","tag-health-insurance","tag-prescription-savings","wpautop"],"acf":[],"yoast_head":"\nAetna Eliquis coverage: Costs, approval, and insurance details<\/title>\n<meta name=\"description\" content=\"Find out how to check your Aetna plan for Eliquis coverage, what steps providers take for approval, and how to reduce out-of-pocket prescription costs.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, 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