What Your Prescriptions Cost
How much does Eliquis cost with Medicare in 2026?
Last reviewed: · Big Sioux Benefits Data Desk
Eliquis has a Medicare-negotiated price of $231 for a 30-day supply as of January 1, 2026, down from a list price of $521, a 56% reduction (CMS, Negotiated Prices for Initial Price Applicability Year 2026). It is the largest drug in Medicare Part D by spending: 3.9 million beneficiaries used it in 2023, accounting for $18.3 billion in Part D gross covered drug costs, more than any other drug in the program.
The qualifier, and it is the one that trips everybody up: $231 is what the drug costs, not what you pay. Your cost is a share of that price, determined by your plan's deductible and cost sharing, and it stops entirely once your out-of-pocket total for the year reaches $2,100. The negotiated price lowers the base that your share is calculated from, which is why it helps, but it is not a copay.
The drop is already visible in the claims data
| Measure | 2025 | 2026 (Q1) |
|---|---|---|
| Average Part D spending per claim | $912.31 | $399.01 |
| Negotiated price, 30-day supply | Not yet in effect | $231.00 |
| List price, 30-day supply (2023 basis) | $521.00 | $521.00 |
That first row is CMS's own claims data, and it is the clearest evidence that the negotiated price took hold: average spending per Eliquis claim fell by more than half in the first quarter of 2026.
What a year on Eliquis looks like
| Step | Illustration under the standard 2026 benefit |
|---|---|
| Drug cost for the year at the negotiated price | About $2,772 |
| You pay during the deductible | Up to $615 |
| You pay after the deductible | 25% of the remaining cost, about $539 |
| Approximate out-of-pocket for the year | About $1,154, under the $2,100 cap |
How this illustration is built: the 2026 standard Part D benefit, meaning a full $615 deductible, then 25% coinsurance, then $0 once your out-of-pocket total reaches $2,100. Your plan may use copays instead of coinsurance, may charge a smaller deductible or none, and may place the drug on a different tier, so treat this as the shape of the year rather than a quote. We are not showing plan-specific copays because we will not publish a number we cannot source.
If Eliquis is your only expensive drug, the negotiated price likely keeps you below the annual cap rather than pushing you to it. If you take it alongside other brand-name drugs, the cap becomes the number that matters, covered in when you hit the $2,100 cap. And if your copay did not visibly fall in January despite the negotiated price, there is a specific reason, explained in why your copay did not drop.
Sources
- CMS — Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2026 — prices effective January 1, 2026; accessed 2026-08-21
- CMS — Medicare Part D Spending by Drug — CY2025 full year and CY2026 Q1 files; accessed 2026-08-21
- CMS — Announcement of Calendar Year 2026 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (Part D benefit parameters) — CY2026 parameters; accessed 2026-08-21
Related questions
Is Eliquis cheaper in 2026 than it was in 2025?
The drug itself is substantially cheaper: the negotiated price of $231 for a 30-day supply replaced a $521 list price, and CMS claims data shows average Part D spending per Eliquis claim falling from $912.31 in 2025 to $399.01 in the first quarter of 2026. Whether your own copay fell depends on how your plan structures cost sharing for that tier.
Is there a generic version of Eliquis?
Eliquis was selected for negotiation precisely because it had no generic or biosimilar competition, which is a statutory requirement for selection. Generic apixaban has been approved but availability has been limited. Ask your pharmacist whether a generic is actually obtainable for you, since that changes the math considerably.
Drug costs turn on your specific prescriptions, so the arithmetic is worth doing once, properly: book a free, no-pressure conversation, see your county's South Dakota plan lineup, or browse all answers. SHIINE, the state's free counseling program, is at 1-800-536-8197 and sells nothing.
Big Sioux Benefits is a licensed insurance agency, not affiliated with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Contact Medicare.gov, 1-800-MEDICARE, or SHIINE (South Dakota's SHIP) for all of your options.