Manufacturer patient assistance
Bristol Myers Squibb Patient Assistance Foundation (BMSPAF)
Bristol Myers Squibb Patient Assistance Foundation
Status: Accepting applications — no closure notice on bmspaf.org on August 26, 2026. Reviews typically take about 3 business days (longer in January–February). No application fee.
The foundation provides Eliquis free of charge to eligible patients who are uninsured for it or who have Medicare and meet the 3% spending rule. Eliquis has its own, higher income limit within the program.
If you have Medicare: Medicare enrollees may qualify if they have spent at least 3% of their yearly household income on out-of-pocket prescription costs in the same calendar year they apply (your pharmacy or Part D plan can print your year-to-date total). Applicants 65 and over, and anyone with income under 150% of the federal poverty level, must include a denial letter from Extra Help (LIS).
What it can cover: Eliquis at no cost for approved patients, shipped per the program's terms.
Who may qualify
- No insurance coverage for Eliquis, OR Medicare plus at least 3% of yearly household income already spent out of pocket on prescriptions this calendar year
- Annual household income at or below $47,880 for one person or $64,920 for two (higher limits for larger households)
- Not eligible for Medicaid — Medicaid-eligible applicants must submit proof of denial
- Age 65+ or income under 150% FPL: proof of Extra Help (LIS) denial required
What the application asks for
- Proof of household income: federal tax return, or 1099s, Social Security statements, pension statements, or two consecutive pay stubs
- Medicare applicants: documentation of year-to-date out-of-pocket prescription spending
- Extra Help (LIS) denial letter if 65+ or under 150% FPL; Medicaid denial if applicable
- Signed patient agreement and consent; prescriber certification signed by your doctor; the Eliquis prescription attached
How to apply
Download the application from bmspaf.org, complete and sign the patient section, ask your doctor to complete, sign and date the prescriber section, and send it to BMSPAF. Decisions are faxed to your doctor and mailed to you.