Eliquis is one of the most widely prescribed blood thinners, so whether Medicare covers it, and what it costs, matters to millions of people. The answer is yes, through the prescription drug part of Medicare, and there is good news on the cost front for 2026. This guide explains how Eliquis is covered, what you will pay, and the recent changes lowering its price. Coverage and costs change, so verify current details before relying on them.
The Short Answer
Yes. Eliquis, whose generic name is apixaban, is covered under Medicare Part D, the prescription drug plans, not under Part B. Your cost depends on your specific plan’s formulary and tier. Two recent changes help: a negotiated lower price takes effect in 2026, and Part D now has an annual out-of-pocket cap.
Which Part of Medicare Covers It
Because Eliquis is a self-administered oral drug you take at home, it is covered by Part D, either a standalone prescription drug plan or a Medicare Advantage plan that includes drug coverage. Original Medicare Parts A and B alone do not cover it, so you need Part D. What you pay, whether a copay or coinsurance, depends on your plan’s formulary and which tier Eliquis falls on, so it is worth comparing plans.
The 2026 Price Negotiation
Here is the significant update. Eliquis was one of the first ten drugs selected for Medicare price negotiation under a 2022 law, and a negotiated lower price takes effect January 1, 2026. Across the ten negotiated drugs, the new prices represent substantial discounts off the previous list prices. One important nuance: the negotiated price is what Medicare and plans pay, and it does not automatically become your copay at the pharmacy, since your cost-sharing still depends on your plan. Still, over time this is expected to reduce costs for people who take Eliquis.
The Part D Out-of-Pocket Cap
The other major help is the annual out-of-pocket cap in Part D, which was set at $2,000 in 2025. Once your covered drug spending reaches the cap in a year, you pay $0 for covered drugs for the rest of the year. For someone on an expensive drug like Eliquis, this cap meaningfully limits what you can be asked to pay across the year.
How to Find the Cheapest Plan
Because cost varies by plan, use the Medicare Plan Finder on Medicare.gov to compare how different Part D plans in your area cover Eliquis, including the tier and your estimated cost. If you take other drugs too, the Plan Finder can compare your whole medication list across plans, which often reveals real savings.
If Cost Is a Problem
If you are struggling with the cost, ask about the Extra Help program, which lowers Part D costs for people with limited income and resources, and check whether the manufacturer offers a patient assistance program, though manufacturer copay cards generally cannot be used with Medicare. Your pharmacist can also tell you whether a lower-cost alternative is appropriate to discuss with your doctor.
Using the Extra Help Program
If Eliquis is straining your budget, help exists. A federal program called Extra Help lowers drug costs.
Extra Help assists people with limited income and resources who have Medicare. It can greatly reduce your premiums, deductibles, and copays for Part D drugs. Many people who qualify do not realize it. It is worth applying through Social Security to see if you qualify.
Other Ways to Lower the Cost
Beyond Extra Help, a few steps can reduce what you pay for Eliquis. Compare your options each year.
Review Part D plans during open enrollment, since one plan may cover Eliquis more cheaply than another. Ask your doctor whether a different anticoagulant might suit you. And check the manufacturer’s savings resources. Small changes can add up to real savings over a year.
Medicare and Eliquis FAQs
Which part of Medicare covers Eliquis?
Part D, the prescription drug coverage, not Part A or B.
Does Original Medicare cover Eliquis?
No. You need a Part D plan or a Medicare Advantage plan with drug coverage.
Is Eliquis getting cheaper?
Yes. A negotiated lower price takes effect January 1, 2026, and the Part D out-of-pocket cap limits yearly costs.
Will the negotiated price be my copay?
Not necessarily. The negotiated price is what Medicare and plans pay; your cost-sharing depends on your plan.
Is there a limit on what I will pay for drugs?
Yes. Part D now caps your annual out-of-pocket drug costs, after which covered drugs are $0.
How do I find the cheapest plan for Eliquis?
Use the Medicare Plan Finder on Medicare.gov to compare plans by how they cover your medications.
Is there help if I cannot afford it?
Yes. The Extra Help program lowers Part D costs for people with limited income and resources.
Is there a generic version of Eliquis?
Apixaban is the generic name. Generic availability and pricing can change, so ask your pharmacist and check how your plan covers it.
Can I use a manufacturer copay card with Medicare?
Generally no. Manufacturer copay cards usually cannot be used with Medicare, but the Extra Help program can lower your costs if you qualify.
What is the Extra Help program?
Extra Help is a Medicare program that lowers Part D premiums, deductibles, and copays for people with limited income and resources. If you qualify, it can substantially reduce what you pay for Eliquis and other drugs.
