Does Molina Healthcare cover Eliquis?

About Eliquis

Eliquis belongs to a class of medications called doac anticoagulants, used to treat blood clot prevention. Because the drug is widely prescribed and well-established, Molina Healthcare — like most large commercial carriers — keeps it on the formulary across most of its plan lineup.

How Molina Healthcare typically covers doac anticoagulants

Molina Healthcare treats the cardiovascular formulary as a retention category. Eliquis sits in a class where the carrier benefits from members filling consistently, so the cost-share is generally kept low and prior authorization is rare on the generic. The brand version may sit a tier higher, with step therapy steering you to the generic first.

What Eliquis typically costs on a Molina Healthcare plan

Cost-wise, Eliquis on Tier 3 (non-preferred brand) typically runs $50–$150 per fill or 20–40% coinsurance on Molina Healthcare plans. Gold and Platinum tiers usually skip the deductible for prescriptions and apply the copay immediately; Silver and Bronze tiers may make you meet a deductible first.

Generic vs. brand

Eliquis is currently brand-only — there is no generic equivalent on the market. That's the single biggest driver of its cost on Molina Healthcare plans, and the reason it sits on tier 3 rather than tier 1. Watch for generic launches; when a generic becomes available, formulary placement typically shifts within 6–12 months.

Prior authorization

Eliquis typically requires prior authorization on Molina Healthcare plans — the carrier wants documentation that you've either tried alternatives or have a clinical reason that makes them inappropriate. It's not a blocker, but it does mean your first fill won't happen the day the prescription is written.

Before you enroll

For Eliquis specifically, the things worth confirming on a Molina Healthcare plan before enrolling are: formulary tier, whether prior authorization applies, the quantity limit per fill (some plans cap at 30 days, others allow 90), and whether the plan has a separate Rx deductible. None of those are knowable from the plan name alone — they're in the formulary document.

Frequently asked questions

Does Molina Healthcare cover Eliquis?

Eliquis is on the formulary for most Molina Healthcare Marketplace plans, typically at Tier 3 (non-preferred brand). Specific coverage, copay, and any prior-authorization requirements vary by individual plan — enter your ZIP to see your county's plans.

What tier is Eliquis on Molina Healthcare's formulary?

On most Molina Healthcare plans, Eliquis sits at Tier 3 (non-preferred brand). Plans in the carrier's lineup occasionally place it differently — Gold and Platinum plans sometimes consolidate tiers, and a small number of Silver plans may move brand drugs up a tier in exchange for lower premiums.

How much does Eliquis cost on a Molina Healthcare plan?

Cost-share at Tier 3 (non-preferred brand) is typically $50–$150 per fill or 20–40% coinsurance once you've met any applicable prescription drug deductible. The actual amount depends on which plan you pick and whether you fill at a preferred pharmacy.

Does Eliquis require prior authorization on Molina Healthcare plans?

Yes, on most Molina Healthcare plans. Your prescriber submits a brief clinical justification; approvals typically come back within 24–72 hours. This is the standard pattern for the carrier and is consistent with how other major Marketplace carriers handle the drug.