Eliquis Patient Assistance Program PDF Guide

Getting Help Paying for Eliquis

Eliquis (apixaban) is one of the most prescribed blood thinners in the United States, used to lower the risk of stroke in people with atrial fibrillation and to treat and prevent deep vein thrombosis and pulmonary embolism. Its retail price for a 30-day supply commonly runs into the hundreds of dollars — frequently quoted in the $550-plus range, though the exact figure varies by pharmacy, region, and year, so treat any single number as an estimate to verify. That cost puts it out of reach for many people without adequate coverage. Bristol Myers Squibb (BMS), the maker of Eliquis, runs an income-based patient assistance program that provides the medication at no cost to qualifying patients.

This article is independent educational information. FMHC is not affiliated with, endorsed by, or sponsored by Bristol Myers Squibb or Pfizer, and we do not administer any Eliquis assistance program. Always confirm current details with the official program before you rely on them.

Where to Apply (and Why “the PDF” Can Be Misleading)

People often search for a single downloadable “Eliquis Patient Assistance Program PDF.” In practice, the safest and most reliable route is to apply directly through the official BMS program rather than hunting for a stray form online, because manufacturers update their applications and enrollment methods over time and an out-of-date form can cause delays or denials. The official starting point is BMS Access Support at bmsaccesssupport.bmscustomerconnect.com, which houses affordability information for BMS medicines including Eliquis and directs eligible patients to the appropriate program.

Free medication for uninsured, income-eligible patients is provided through the Bristol Myers Squibb Patient Assistance Foundation, an independent charitable organization. Your prescriber’s office is a key partner here: many clinics enroll patients in manufacturer assistance programs routinely and can help you start the application, complete the clinical portion, and submit it. Rather than printing a phone number that may change, we recommend reaching the program through the official website above, through the contact information your prescriber’s office has on file, or through the materials that come with your prescription. Whenever you see a specific figure or form referenced online, verify it against the official BMS source before acting on it.

Who Generally Qualifies

The BMS Patient Assistance Foundation is designed for patients who cannot afford their medication and lack sufficient insurance coverage. General requirements have typically included:

• U.S. residency: You must be a legal resident of the United States or its territories.
• Insurance status: The free-drug foundation program is generally aimed at patients who are uninsured or lack prescription drug coverage. People with Medicare Part D face separate rules (see below).
• Income threshold: Household income must fall at or below a limit set by BMS, historically in the range of roughly 300% to 400% of the Federal Poverty Level. Because these limits are set by the manufacturer and updated annually, do not rely on a fixed dollar figure — confirm the current threshold for your household size directly with the program.

Patients enrolled in Medicaid, VA benefits, or TRICARE are generally directed to those benefits instead. Medicare Part D enrollees are handled under a different set of rules and are often better served by the resources described later in this guide. Eligibility is ultimately determined by BMS based on its current criteria, so the details above are a starting point, not a guarantee.

What You Will Need to Apply

Manufacturer assistance applications are typically divided into sections for the patient, the prescriber, and income documentation. Preparing these in advance speeds things up.

Patient Information

You will provide identifying and contact information and details about your insurance status (whether you have Medicare, Medicaid, or private coverage). Accurate contact details matter, because the program uses them to reach you about your application status.

Prescriber Information

Your prescribing clinician completes and signs the clinical section, confirming the prescription and medical necessity. A prescriber signature is required — applications missing it are returned. Note that specific dosing is a decision your prescriber makes and documents; there is no copy-and-paste dose, and you should never adjust your regimen on your own.

Income Verification

You must document household income. Commonly accepted items include:

• Most recent federal tax return (Form 1040)
• W-2 or 1099 forms
• Social Security benefits letter (SSA-1099)
• Recent pay stubs
• A signed statement of zero income, if applicable

How the Process Works

Broadly, the steps are: start through the official BMS program; complete the patient section accurately; have your prescriber complete and sign the clinical section (many offices handle these requests routinely); attach your income documentation, keeping copies for your records; submit through the method the program specifies; and then wait for a decision. Processing commonly takes a few weeks. If approved, medication is typically provided at no cost, often shipped to your prescriber’s office or to you as the program directs. If you have not heard back within the program’s stated timeframe, follow up through the official channel.

If Your Application Is Denied

Denials are not always final. Common reasons include income above the program’s threshold, insurance the program considers adequate, or an incomplete application. If you are denied on income, check whether your state offers a pharmaceutical assistance program (SPAP). If your circumstances change — for example, you lose insurance or your income drops — you can generally reapply. And if you have commercial insurance, the copay card described next may lower your cost even if you do not qualify for the free-drug program.

Other Ways to Save on Eliquis

Eliquis copay savings card (commercial insurance only): For patients with commercial/private insurance, BMS offers a copay savings card that can substantially reduce monthly out-of-pocket cost. By law, manufacturer copay cards cannot be used by people with Medicare, Medicaid, TRICARE, or other government insurance. Terms and maximum savings change, so confirm current details on the official Eliquis site.

Discount cards: GoodRx and similar platforms sometimes list cash prices below full retail. Prices vary widely by pharmacy and change frequently, so compare before assuming a discount card is your cheapest option. These can help as a bridge while other assistance is pending.

Medicare beneficiaries — important 2026 update: Medicare’s old Part D “donut hole” coverage gap has been eliminated. Under the Inflation Reduction Act, Part D now has an annual cap on out-of-pocket prescription spending — about $2,100 in 2026 (up from $2,000 in 2025) — after which you pay nothing more for covered drugs for the rest of the year. Medicare also offers the Medicare Prescription Payment Plan, which lets you spread your out-of-pocket costs into monthly installments across the year at no added charge. For lower-income beneficiaries, the Extra Help program (Low-Income Subsidy) can dramatically reduce or eliminate Part D premiums and copays; the exact copay amounts are set each year, so verify the current figures. You can apply through Social Security. These Medicare pathways often help more than a manufacturer program for people with Part D. (Older guides that describe a “coverage gap” you must reach are out of date — verify current Medicare rules at Medicare.gov.)

340B pharmacies: 340B-eligible pharmacies receive discounted drug prices and may pass some savings along. Ask your provider whether they participate.

Eliquis Safety Essentials You Should Know

Cost is only one part of the picture. Because Eliquis is a blood thinner, a few safety points are important — and one common myth needs correcting. This section is educational and does not replace your prescriber’s instructions.

• Never stop Eliquis on your own. Apixaban is a factor Xa inhibitor anticoagulant. Stopping it suddenly — including because you cannot afford a refill — can significantly raise your risk of a stroke or dangerous blood clot. If cost is the problem, talk to your prescriber or pharmacist right away about assistance options before you run out; do not simply stop.
• Bleeding is the main risk. Watch for signs such as unusual bruising, nosebleeds that won’t stop, pink or brown urine, red or black/tarry stools, coughing or vomiting blood (which may look like coffee grounds), or heavy or prolonged bleeding. Get medical care for serious or uncontrolled bleeding, and call 911 for severe bleeding, or for signs of bleeding in the brain such as a sudden severe headache, weakness, confusion, or trouble speaking or seeing.
• No vitamin K diet restriction — that’s a warfarin rule, not an Eliquis rule. Unlike warfarin, apixaban does not require you to limit vitamin K foods (leafy greens like spinach and kale), and it does not require routine INR blood-level monitoring. Per MedlinePlus, people on apixaban can generally continue their normal diet unless their clinician says otherwise. Confusing the two drugs is a common and avoidable mistake.
• Interactions matter. NSAID pain relievers (ibuprofen, naproxen), aspirin, and other blood thinners raise bleeding risk. Certain other medicines — including some antifungal and antiviral drugs (strong CYP3A4/P-gp inhibitors such as ketoconazole, itraconazole, and ritonavir) — can change apixaban levels. Tell every prescriber and pharmacist that you take Eliquis, and check before adding any new medicine or supplement.
• No copy-able dosing. The correct dose depends on your condition, kidney function, age, weight, and other medicines. Only your prescriber should set or change it.

Frequently Asked Questions

Is there a generic version of Eliquis available?

As of early 2026, patent litigation has delayed a widely available generic apixaban in the United States, and generic entry is anticipated but has repeatedly shifted. Availability can change quickly, so verify the current situation with your pharmacist or the FDA/DailyMed. When a generic does launch broadly, prices are expected to fall. See our generic vs. brand-name drugs guide for context.

Can Medicare patients use the Eliquis Patient Assistance Program?

Medicare Part D enrollees are handled under separate rules and are often better served by Medicare’s own protections — the annual out-of-pocket cap, the Medicare Prescription Payment Plan, and Extra Help. Confirm your options through the official BMS program and Medicare.gov.

How long does approval take?

Manufacturer programs commonly take a few weeks to process a complete application. Timeframes change, so follow the current guidance from the official program and follow up if you have not heard back.

Do I need to reapply?

Yes. Enrollment is generally time-limited (often up to 12 months) and requires updated income documentation to renew. The program typically notifies you before your enrollment period ends.

What if I can’t afford my next refill right now?

Do not stop taking Eliquis without talking to your prescriber — stopping raises stroke and clot risk. Contact your prescriber or pharmacist immediately about bridge supplies, the copay card (if you have commercial insurance), Medicare options, or the BMS assistance program.

Take the Next Step Safely

If Eliquis is straining your budget, help exists — but the safe path is to keep taking your medication and pursue assistance at the same time. Start through the official BMS program, ask your prescriber’s office for help with the application, and, if you have Medicare, compare the Part D out-of-pocket cap, the Medicare Prescription Payment Plan, and Extra Help. For more cost-saving strategies across all your medications, visit our healthcare costs guide.

Sources

• Bristol Myers Squibb — BMS Access Support and the BMS Patient Assistance Foundation, official program site (verify current eligibility and application)
• Eliquis (apixaban) official site (copay card terms, safety)
• MedlinePlus (U.S. National Library of Medicine), Apixaban (safety, no vitamin K restriction, do not stop without talking to your doctor)
• U.S. Food and Drug Administration — Eliquis (apixaban) prescribing information (via FDA/DailyMed)
• CMS / Medicare.gov — 2026 Part D out-of-pocket cap and the Medicare Prescription Payment Plan (verify current figures)