{"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":"2026-01-30T11:23:50","modified_gmt":"2026-01-30T16:23:50","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":"

Eliquis<\/span><\/a> is a brand-name drug and <\/span>anticoagulant<\/span><\/a> with FDA approval. The name of the generic drug is the same as the medication\u2019s active ingredient: apixaban. However, a generic version is not currently available.\u00a0<\/span><\/p>\n

People may take prescription medications like this one for various reasons, such as the prevention or treatment of <\/span>blood clots<\/span><\/a>, including <\/span>deep vein thrombosis (DVT)<\/span><\/a> or a <\/span>pulmonary embolism (PE)<\/span><\/a>, and the prevention of strokes in people with atrial fibrillation. When it comes to costs and coverage, <\/span>Eliquis<\/span><\/a> is typically covered by most health insurance plans, including Medicare Part D and some state Medicaid programs.<\/span><\/p>\n\t\t

\n\t\t\t

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\n

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

Medication coverage varies by insurance policy and plan, and health insurance falls under state regulations more than federal regulations, as the <\/span>Kaiser Family Foundation<\/span><\/a> points out. As far as Aetna and their plans, at least some cover Eliquis. For example, the <\/span>2025 Advanced Control Plan<\/span><\/a> covers a 5 mg oral tablet and a 2.5 mg oral tablet.\u00a0<\/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. \u201cThe criteria for a prior authorization for Eliquis usually is either treatment for DVT or pulmonary embolism,\u201d says Dr. Deepak Khanna, DO, an internist and family medicine physician at UPenn and the founder of dandRX, an FDA-approved anti-dandruff shampoo. \u201cOr especially in those patients who are recently postoperative, they usually require a 30- to 45-day Eliquis dose to prevent a DVT.\u201d\u00a0<\/span><\/p>\n

If a patient has <\/span>DVT<\/span><\/a>, it may show up in ultrasound imaging or D-dimer blood test results. There is generally no special preparation required to get accurate results on a D-dimer test.<\/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, this would be an off-label use.\u00a0<\/span><\/p>\n

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

Healthcare providers are in charge of getting patients approved. \u201cTypically, when I am tasked to do a prior authorization \u2026 It involves me calling the prior authorization phone number,\u201d Dr. Khanna says. \u201cI explain to them the rationale for why the patient needs this medication and why no other medication would be beneficial for this patient.\u201d<\/span><\/p>\n

That\u2019s why healthcare providers are needed here: They affirm the medical necessity for an individual patient to get Eliquis. \u201cIf 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,\u201d Dr. Khanna continues.\u00a0<\/span><\/p>\n

Medical professionals are also helpful in that they create different treatment plans when problems occur. For example: \u201cIf the patient requires an anticoagulation medication like Eliquis, but the prior authorization is denied, then I will look at alternatives like Coumadin,\u201d Dr. Khanna says.\u00a0<\/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. Most practices aim to provide thorough service that leads to the highest patient satisfaction.<\/span><\/p>\n

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

Without insurance<\/span><\/a>, Eliquis typically costs $398 for 28, 5 mg tablets at state-licensed pharmacies. Although insurance may help cover the cost of Eliquis, additional charges may apply. The <\/span>average copay varies<\/span><\/a>, but is about $39 per month or even as low as $10 per month when it\u2019s 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\u2019ll use Aetna\u2019s 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 \u201cFind medicine\u201d 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 who don\u2019t have insurance and need help covering the costs of Eliquis, SingleCare offers <\/span>prescription discount cards<\/span><\/a>, including an <\/span>Eliquis coupon<\/span><\/a> and coupons for additional medications. All you need to do is click \u201cGet free coupon\u201d under the store you plan to get the medication from, and 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 the manufacturer offers savings options like coupon cards or other programs. You can also ask a healthcare provider about alternatives or changing health insurance plans. 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":"

    Eliquis is a brand-name drug and anticoagulant with FDA approval. The name of the generic drug is the same as the medication\u2019s active ingredient: apixaban. However, a generic version is not currently available.\u00a0 People may take prescription medications like this one for various reasons, such as the prevention or treatment of blood clots, including deep […]<\/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 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