Eliquis is expensive on Medicare because the drug manufacturer sets a high price, Medicare cannot negotiate that price directly, and your out-of-pocket costs depend on which coverage stage you're in

Eliquis (apixaban) is a blood thinner used to prevent blood clots and stroke. A month's supply can cost $400 to $600 before any insurance. Medicare Part D covers it, but you pay different amounts depending on whether you're in the deductible stage, the initial coverage stage, or the catastrophic coverage stage. The manufacturer, Bristol Myers Squibb, sets the price — and until very recently, Medicare was legally barred from negotiating drug prices directly with manufacturers.

The high cost reflects both the drug's value (it works well and has few interactions with other medications) and the fact that there's no generic version yet. Patent protections keep competitors out until 2026 at the earliest. That means if your doctor prescribes Eliquis, you're paying for a brand-name drug with limited alternatives, and your Medicare plan passes much of that cost to you.

Key Takeaways

  • Eliquis costs $400 to $600 per month before insurance because the manufacturer sets the price and no generic version exists yet.
  • Your out-of-pocket cost on Medicare Part D depends on your coverage stage: you pay the full price during the deductible, a percentage during initial coverage, and a smaller percentage in catastrophic coverage.
  • Medicare Part D plans vary widely in how much they charge for Eliquis, so comparing plans during open enrollment can lower your costs by hundreds of dollars per year.
  • Manufacturer discount programs and patient information programs can reduce your cost even if you're uninsured or underinsured, though they have income limits.
  • Asking your doctor about lower-cost alternatives like warfarin or dabigatran may be an option depending on your medical history.

How Medicare Part D Coverage Stages Affect Your Eliquis Cost

Medicare Part D divides the year into coverage stages, and you pay a different share of the drug cost in each one. In the deductible stage, you pay the full price out of pocket until you reach your plan's deductible (usually $505 to $550 in 2024, though this varies by plan). At $400 to $600 per month, you'll hit that deductible in one or two fills.

Once you've met the deductible, you enter initial coverage. Here, you pay a copay or coinsurance — typically 20 to 25 percent of the drug's cost. For Eliquis, that's roughly $80 to $150 per month. You stay in this stage until your total drug costs (what you and your plan pay combined) reach about $5,850. After that, you enter the coverage gap (the "donut hole"), where you pay 25 percent of the cost again. Once your out-of-pocket spending hits roughly $8,550, you move into catastrophic coverage, where Medicare pays most of the cost and you pay only a small copay.

The stage you're in when you fill your prescription matters enormously. A January fill during the deductible stage costs far more than a December fill during catastrophic coverage.

Why the Price Is So High: Patent Protection and Lack of Competition

Eliquis has no generic competitor because Bristol Myers Squibb holds patents that protect the drug until at least 2026. Patents give a manufacturer the sole right to sell a drug at whatever price they choose. Once a generic version becomes available, the price typically drops 80 to 90 percent because multiple manufacturers compete.

The manufacturer argues the high price reflects the cost of developing the drug, running clinical trials, and marketing it. Those costs are real — bringing a new drug to market can cost $2 billion or more. But the price also reflects what the market will bear. In the United States, patients and insurers pay more for brand-name drugs than patients in other countries do for the same medication. Medicare was forbidden by law to negotiate prices directly with manufacturers until 2023, when Congress passed the Inflation Reduction Act. Even now, Medicare can only negotiate prices for a small number of drugs each year, and Eliquis is not yet on that list.

Comparing Medicare Part D Plans to Find Lower Costs

Not all Medicare Part D plans charge the same amount for Eliquis. Some plans place it on a higher tier (meaning you pay more), while others put it on a lower tier. The difference can be $50 to $100 per month. During the annual open enrollment period (October 15 to December 7), you can switch to a plan with a lower Eliquis copay.

To compare, visit Medicare.gov and use the Plan Finder tool. Enter Eliquis as a drug you take, and the tool will show you the copay for each plan in your area, ranked from lowest to highest. You can also see the plan's deductible, monthly premium, and which pharmacies are in-network. Some plans with lower premiums charge more for Eliquis; others charge less for the drug but have a higher monthly premium. The Plan Finder calculates your total estimated cost for the year, which helps you decide whether switching is worth it.

If you switch plans, make sure your pharmacy is in-network and that your doctor's preferred dosage (usually 5 mg twice daily) is covered without prior authorization. Some plans require you to try a different blood thinner first before they'll cover Eliquis.

Manufacturer Discounts and Patient information Programs

Bristol Myers Squibb offers a copay information program for Eliquis. If you have commercial insurance or Medicare Part D, you may pay as little as $10 per month, with the manufacturer covering the rest of your copay up to a certain limit. The program has income limits — you must earn less than roughly $100,000 per year as an individual or $200,000 as a couple — but many people on Medicare fall within those bounds.

To enroll, visit the Eliquis website or call the manufacturer's patient information line. You'll need to provide proof of income and insurance. The process usually takes a few days. If you're uninsured or your income is below the poverty line, Bristol Myers Squibb also offers a separate program that provides Eliquis free or at a reduced cost.

These programs are separate from Medicare and don't count toward your Part D deductible or out-of-pocket maximum. That means the copay information is truly additional help, not a substitute for your insurance coverage.

Lower-Cost Alternatives Your Doctor Might Consider

Eliquis is one of four newer blood thinners (called direct oral anticoagulants, or DOACs) used to prevent stroke in people with atrial fibrillation or to treat blood clots. The others are dabigatran (Pradaxa), rivaroxaban (Xarelto), and apixaban's competitor, edoxaban (Savaysa). All four work similarly, but their costs and insurance coverage vary.

Warfarin, an older blood thinner, is much cheaper — often $10 to $30 per month — but it requires monthly blood tests and has more drug interactions. Some people do well on warfarin; others find the monitoring burdensome or have medical reasons to avoid it. Dabigatran is sometimes cheaper than Eliquis on certain Medicare plans, though not always. If cost is a barrier, ask your doctor whether switching to dabigatran or another DOAC might work for your situation. Never stop taking Eliquis or switch blood thinners on your own — blood clots and stroke are serious risks — but your doctor can help you weigh the options.

What Happens If You Can't Afford Your Copay

If your copay is still too high even after exploring plans and information programs, tell your doctor and pharmacist. Some pharmacies offer their own discount programs (GoodRx, SingleCare, RxSaver) that may be cheaper than your Medicare copay for a single fill. You can use these programs even if you have Medicare, though the discount doesn't count toward your Part D deductible or out-of-pocket maximum.

Your doctor might also prescribe a smaller quantity — say, a 15-day supply instead of 30 days — to spread the cost across two copays in different months. This doesn't reduce the total cost, but it can help if you're short on cash in a particular month. Some people also ask their doctor to write a prescription for a higher dose (like 10 mg) that they split in half, though this only works if your doctor agrees it's medically safe.

If you're struggling financially, contact your local Area Agency on Aging or a patient advocate at your hospital. They can connect you with other resources, including pharmaceutical company programs you might not know about.

Frequently Asked Questions

Will a generic Eliquis become available soon?

A generic version of apixaban may become available in 2026 or later, depending on patent challenges and FDA approval. Once it does, the price will likely drop significantly. Until then, you're paying for a brand-name drug with limited competition.

Can I use a GoodRx coupon instead of my Medicare Part D plan?

Yes, you can use GoodRx or similar discount programs for any fill, even if you have Medicare Part D. Compare the GoodRx price to your Part D copay and use whichever is lower. The discount doesn't count toward your deductible or out-of-pocket maximum, so it's purely a per-fill savings.

Does switching Medicare plans mid-year cost anything?

No. You can switch Part D plans during the annual open enrollment period (October 15 to December 7) at no penalty. If you have a life-changing event — like losing other insurance or moving — you may be able to switch outside open enrollment. Contact Medicare at 1-800-MEDICARE to ask.

What if my plan requires prior authorization for Eliquis?

Prior authorization means your plan wants your doctor to confirm the drug is medically necessary before they'll cover it. Your doctor's office usually handles this by submitting a form to the plan. It typically takes a few days. Ask your pharmacy to submit the request as soon as your prescription is filled so you're not delayed.

Can I ask my doctor to prescribe a different blood thinner to save money?

Yes, you can ask. Your doctor may be open to trying dabigatran, warfarin, or another option if cost is a real barrier. But the choice depends on your medical history, kidney function, and other medications. Never switch blood thinners without your doctor's approval, as the risk of blood clots or bleeding is serious.