12/9/2023 0 Comments Keystone safari coupon![]() Some insurance plans may not cover ELIQUIS, or will ask that a formulary exception request be submitted. Prior authorization: If your insurance plan needs prior authorization before approving coverage of ELIQUIS, live specialists can help coordinate the process among your doctors, insurer, and pharmacist, and get the paperwork submitted.įormulary exception requests: A formulary is an insurance company’s list of covered medications. You can provide your e-signature by visiting If you have questions along the way, our live specialists are availableĪt 1-855-ELIQUIS (354-7847), Monday-Friday, 8 AM – 8 PM ET. Patient Authorization and Agreement form. Before we can contact your health plan to confirm your coverage details, you must sign a Our live specialists can contact your insurance company to research your prescription insurance benefits for ELIQUIS and explain them to you-including whether ELIQUIS is covered by your Help you find out if ELIQUIS is covered by your insurance planĭetermine if you are eligible for assistance paying for ELIQUISĬheck if you qualify for the ELIQUIS Co-pay Card Please see Full Prescribing Information, including Boxed WARNINGS and Medication Guide.Ĭall Tap to call 1-855-ELIQUIS (354-7847) from Monday – Friday, 8 AM – 8 PM (ET). To the pharmacist: For processing assistance, please call tap to call McKesson Pharmacy Support This offer may not be redeemed on prescriptions written for longer than 30 days Patient is responsible for applicable taxes, if any. Present your activated Free Trial Offer Card to your pharmacist along with yourĮligible patients who present a Free 30-Day Trial card together with a valid 30-day prescription for ELIQUIS at participating pharmacies can receive a free 30-day supply (up to 74 tablets) of ELIQUIS. The Co-pay Card will be accepted only at participating pharmacies. For those customers using mail-order or any non-participating retail pharmacy, please call tap to call 86 to request a patient rebate form, or go to to download a formīy using this card, you and your pharmacist understand and agree to comply with the eligibility requirements and terms of use Patient is responsible for applicable taxes, if any Eligibility and terms and conditions apply. Present your activated Co-pay Card to your pharmacist, along with your ELIQUIS prescriptionĮligible patients who present an activated Co-pay Card together with a valid prescription for ELIQUIS at participating pharmacies may pay as little as $10 per 30-day supply (up to 74 tablets for the first fill, and up to 60 tablets for all subsequent fills) for up to 24 months, subject to a maximum annual benefit of $6,400.For commercially insured patients.
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