Eliquis (apixaban) is one of the most widely prescribed blood thinners in the country, used to reduce stroke risk in atrial fibrillation and to treat or prevent blood clots. Without insurance, a month's supply routinely costs several hundred dollars, which is a serious burden for the older, often fixed-income population that relies on it most.
Because Eliquis is co-marketed by Bristol Myers Squibb and Pfizer, patient support runs through Eliquis 360 Support, which oversees both a commercial copay card and a separate, income-qualified Patient Assistance Foundation. These are not the same program, and mixing them up is one of the most common reasons patients apply to the wrong track and get delayed.
This guide walks through exactly who qualifies for the Patient Assistance Foundation, how Medicare patients specifically fit in, what documents you need, and what to do if your household income is just above the cutoff.
Table of Contents
- Eliquis 360 Support: Two Separate Programs
- Who the Patient Assistance Foundation Is For
- Income Eligibility Requirements
- Why Medicare Patients Are Treated Differently
- Required Documents
- How to Apply, Step by Step
- How Long Approval Takes
- How Medication Is Delivered
- Renewing Your Enrollment
- What to Do If You're Denied or Over the Income Limit
- Frequently Asked Questions
Eliquis 360 Support: Two Separate Programs
"Eliquis 360 Support" is the umbrella patient support brand, but it splits into two distinct paths depending on your insurance situation. Confusing the two is the single most common mistake patients make when searching for help affording Eliquis.
| Program | Who It's For | What It Does | Cost to Patient |
|---|---|---|---|
| Eliquis Copay Card | Commercially insured patients | Reduces out-of-pocket copay | Reduced copay, not $0 |
| Patient Assistance Foundation | Uninsured/underinsured, income-eligible patients | Provides medication at no cost | Typically $0 |
Key distinction: The copay card is a discount for people who already have commercial insurance. The Patient Assistance Foundation is a separate charitable program for people without adequate coverage. Federal healthcare program beneficiaries, including Medicare and Medicaid patients, generally cannot use the copay card at all.
Who the Patient Assistance Foundation Is For
The foundation exists specifically for patients who would otherwise go without a clinically necessary blood thinner because of cost. It's a charitable access program, not an insurance product.
| Feature | What It Means |
|---|---|
| Cost to Patient | Typically $0 for approved medication |
| Who Administers It | Bristol Myers Squibb Patient Assistance Foundation |
| Funding Source | Manufacturer-funded charitable assistance |
| Enrollment Period | Typically 12 months, then reapplication required |
| Underlying Requirement | No adequate prescription coverage + income eligibility |
Income Eligibility Requirements
Income thresholds are based on the federal poverty level (FPL) and household size. Programs tied to medications used heavily by older, fixed-income populations — like Eliquis — often set the threshold somewhat higher than programs for other drug categories, though applicants should confirm the exact current figure when applying.
| Household Size | Approximate Income Threshold (~500% FPL) |
|---|---|
| 1 Person | ~$78,250 |
| 2 People | ~$105,750 |
| 3 People | ~$133,250 |
| 4 People | ~$160,750 |
Federal poverty level figures update annually and vary slightly for Alaska and Hawaii. These figures are approximate; confirm your exact threshold against the current year's guidelines and the specific limit published by the foundation at the time you apply.
Why Medicare Patients Are Treated Differently
Because federal law prohibits manufacturers from offering copay cards to patients enrolled in federal healthcare programs, Medicare beneficiaries can't use the commercial Eliquis copay card. That doesn't mean Medicare patients are left without options — it just means the path looks different.
| Insurance Situation | Copay Card Eligible? | Patient Assistance Foundation Eligible? |
|---|---|---|
| Commercial insurance | Yes | Usually No — already adequately covered |
| No insurance | No | Usually Yes, if income-eligible |
| Medicare Part D | No — federal program restriction | Case-by-Case |
| Medicaid | No — federal program restriction | Case-by-Case |
Medicare patients who fall into the Part D coverage gap, or whose plan places Eliquis on a high-cost tier, are often better served by independent nonprofit copay assistance foundations (such as those supporting cardiovascular or clotting disorders) or the Medicare Extra Help / Low-Income Subsidy program, in addition to checking Patient Assistance Foundation eligibility directly.
Required Documents
Incomplete applications are the most common reason for delay. Gathering these documents up front shortens the process considerably.
| Document | Purpose |
|---|---|
| Completed patient section of application | Confirms identity, address, household size and insurance status |
| Completed prescriber section of application | Confirms diagnosis and medical necessity for apixaban |
| Proof of income | Recent tax return, pay stubs, or Social Security/pension statement |
| Proof of insurance status | Insurance card, denial letter, or evidence of no drug coverage |
| Valid prescription | Confirms dose (2.5 mg or 5 mg) and indication |
Step-by-Step: How to Apply
Confirm you need the Patient Assistance Foundation, not the copay card
If you have Medicare, Medicaid, or no insurance at all, the copay card isn't an option — you'll want the foundation application instead.
Request the application
Applications are available through Eliquis 360 Support's patient assistance materials or by phone, and are often provided directly by your prescriber's office.
Complete the patient section
Fill in your personal information, household size, income, and current insurance status, including Medicare or Medicaid enrollment if applicable.
Have your prescriber complete their section
Your provider confirms your diagnosis (such as atrial fibrillation or venous thromboembolism), the prescribed dose, and medical necessity.
Attach income and insurance documentation
Include recent proof of income and documentation showing your lack of adequate prescription coverage for Eliquis specifically.
Submit and await a decision
Applications are typically submitted by fax or mail. You'll receive written notification of approval or denial along with next steps.
How Long Approval Takes
| Situation | Typical Timeframe |
|---|---|
| Complete application, first submission | 2–4 weeks |
| Application missing documents | Additional 2–3 weeks after resubmission |
| Renewal application (previously enrolled) | 1–3 weeks |
Because Eliquis is a maintenance medication taken long-term to prevent stroke or clotting events, avoid letting your supply run out while waiting on an application — talk to your prescriber about bridging options if a decision is taking longer than expected.
How Medication Is Delivered
Approved medication is typically not shipped directly to a patient's home. It generally ships to the prescriber's office or an affiliated pharmacy for pickup.
| Step | What Happens |
|---|---|
| Approval Notification | Patient and prescriber's office are both notified |
| Shipment Scheduled | Coordinated with the prescriber's office |
| Pickup | Patient collects medication from the prescriber's office |
| Refill Requests | Typically require a new request before each shipment during enrollment |
Decision Tree: Which Program Should You Apply To?
Step 1: Do you have commercial insurance (not Medicare or Medicaid)?
✔ Yes → Use the Eliquis copay card, not the Patient Assistance Foundation.
✖ No → Continue to Step 2.
Step 2: Is your household income within the foundation's limit for your household size?
✔ Yes → Continue to Step 3.
✖ No → Look into independent nonprofit foundations or Medicare Extra Help instead.
Step 3: Do you have a valid prescription and a provider willing to complete the application?
✔ Yes → You're likely a strong candidate for the Patient Assistance Foundation — begin the application.
✖ No → Schedule an appointment first; the prescriber section is required before submission.
Renewing Your Enrollment
Enrollment isn't indefinite. Most patients need to reapply, typically annually, with updated documentation.
- Start the renewal process a few weeks before your current enrollment period ends to avoid a gap in your blood thinner supply.
- Provide updated income documentation, even if your income hasn't meaningfully changed.
- Confirm your prescriber's office still has your case on file, since renewal also requires a prescriber signature.
- Report any change in insurance status right away, since gaining new coverage may change your eligibility mid-cycle.
Because Eliquis reduces stroke and clotting risk, an unplanned gap in access carries real medical risk. Don't wait until your last dose to start the renewal process.
What to Do If You're Denied or Over the Income Limit
A denial doesn't have to be the end of the road. Most denials trace back to income, missing documentation, or an insurance situation the program considers adequate.
| Reason for Denial | What It Means | Next Step |
|---|---|---|
| Income above threshold | Household income exceeds the foundation's limit | Explore independent nonprofit copay foundations or state assistance programs |
| Missing documentation | Application was incomplete | Resubmit with all required documents attached |
| Existing adequate coverage | Program considers your current insurance sufficient | Use the Eliquis copay card instead, if commercially insured |
| Incomplete prescriber section | Provider signature or diagnosis information missing | Return to your prescriber's office to complete the form |
Alternative Assistance Options for Eliquis
| Resource | What It Offers |
|---|---|
| Independent Cardiovascular/Anticoagulation Foundations | Copay and premium assistance grants specifically for clotting and cardiovascular diagnoses |
| Medicare Extra Help (Low-Income Subsidy) | Reduces Part D premiums, deductibles, and copays for qualifying Medicare beneficiaries |
| State Pharmaceutical Assistance Programs | State-run supplemental drug coverage for eligible residents |
| Generic Apixaban (When Appropriate) | Lower-cost alternative your prescriber can discuss once available on your formulary |
Common Mistakes That Delay an Eliquis PAP Application
- □ Applying for the copay card while enrolled in Medicare or Medicaid (not eligible).
- □ Prescriber section left blank or unsigned.
- □ Income documentation doesn't match the household size listed.
- □ Insurance status documentation missing (denial letter or coverage exclusion not attached).
- □ Application submitted for the wrong dose (2.5 mg vs. 5 mg).
- □ Outdated income documents older than the program's accepted window.
- □ Renewal submitted after the enrollment period already lapsed.
Nearly all of these issues are simple paperwork mismatches. Double-checking every section before submission avoids the most common delays.
Quick Checklist Before You Submit
| Checklist Item | Status |
|---|---|
| Confirmed you're applying to the correct program (Foundation vs. copay card) | ☐ |
| Patient section fully completed | ☐ |
| Prescriber section signed and completed | ☐ |
| Recent proof of income attached | ☐ |
| Proof of insurance status attached | ☐ |
| Valid prescription matches requested dose | ☐ |
Bottom Line
The Eliquis Patient Assistance Foundation exists specifically for uninsured or underinsured, income-qualifying patients — it's a separate program from the commercial copay card, and Medicare and Medicaid beneficiaries need to go through the foundation or an independent nonprofit rather than the copay card. Getting approved quickly comes down to submitting a complete application: patient and prescriber sections filled out fully, current income documentation attached, and clear proof that your existing coverage doesn't adequately pay for Eliquis.
If you're denied or your income is just above the threshold, independent cardiovascular and anticoagulation foundations, Medicare Extra Help, and state pharmaceutical assistance programs are all worth exploring so a stroke-prevention medication doesn't go unfilled.
Frequently Asked Questions
Eligibility generally requires being a U.S. resident, having no adequate prescription drug coverage for Eliquis, and meeting household income limits that are typically higher than many other manufacturer assistance programs, adjusted for household size.
Medicare patients generally cannot use the manufacturer copay card due to federal restrictions, but many qualify for the Patient Assistance Foundation, independent nonprofit copay foundations, or the Medicare Extra Help (Low-Income Subsidy) program instead.
Eliquis 360 Support is the broader patient support brand that includes a commercial copay savings card for insured patients. The Patient Assistance Program is a separate, income-based track administered through the Bristol Myers Squibb Patient Assistance Foundation that provides medication at no cost to eligible uninsured or underinsured patients.
Complete applications are often reviewed within two to four weeks. Applications missing documents take longer, since the foundation must request the missing information before continuing review.
Yes. The application requires a prescriber section confirming your diagnosis, prescribed dose, and medical necessity. Applications without this section completed will not be processed.
Usually not directly. Approved medication is typically shipped to your prescriber's office or an affiliated pharmacy, and you pick it up from there.
Yes. Enrollment is typically granted for a set period, often around 12 months, after which you must reapply and resubmit updated income and insurance documentation.
If your household income exceeds the foundation's threshold, you likely won't qualify for this specific program. Independent cardiovascular or anticoagulation-focused foundations, Medicare Extra Help, and state pharmaceutical assistance programs are worth exploring as alternatives.
Often yes. Insurance that excludes Eliquis or leaves it functionally unaffordable can still qualify as inadequate coverage, but you'll typically need documentation, such as a formulary exclusion notice or denial letter, to support this.
Generic apixaban availability and pricing can change, so it's worth asking your prescriber and pharmacist whether a generic option is currently available and appropriate for your situation, since it may be significantly less expensive than the brand-name product.
A change in insurance status is exactly the kind of situation the Patient Assistance Foundation is designed for. You can apply or reapply reflecting your new insurance and income situation as soon as the change takes effect.
How We Researched This Guide
References
- Bristol Myers Squibb / Pfizer. Eliquis 360 Support Program Overview and Application Materials.
- Bristol Myers Squibb Patient Assistance Foundation. Eligibility and Application Guidance.
- U.S. Department of Health and Human Services. Federal Poverty Level Guidelines.
- Centers for Medicare & Medicaid Services. Medicare Part D Extra Help and Low-Income Subsidy Guidance.
- Office of Inspector General, U.S. Department of Health and Human Services. Anti-Kickback Statute Guidance on Manufacturer Copay Assistance.
Related Resources
- Complete Prior Authorization Guide (2026)
- Novo Nordisk Patient Assistance Program
- CVS Caremark Prior Authorization
- How to Appeal a Prescription Denial
- Medicare GLP-1 Bridge Program
Editorial Policy: Refill Relay content is researched using publicly available manufacturer patient assistance program materials, federal poverty guidelines, and standard industry application practices. Every article is reviewed for clarity, accuracy and usefulness before publication.