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Cost of Evenity injections
Does anyone know what is the out of pocket cost for Evenity if one has traditional Medicare with a supplement vs Medicare advantage program?
I was told by Aetna Medicare Advantage CONY the the out of pocket cost is $602.89
for each injection visit. They said Evenity is a tier V medication. I heard Medicare part B covers 80% and Medigap or supplement covers 20%. However I think the out of pocket cost for every Evenity visit would be costly.. appreciate a reply and thanks. Shula
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I am so grateful that you shared this with us. I didn't know about Amgen Support+ Co-pay Program. I went straight to the site and enrolled. My first injection is in 10 days.
Hi hopefullibrarian,
Have you received a bill yet from your provider or statement from your insurance?
Thanks, good luck.
Hi @ashash,
I got the EOB on Friday, and submitted it to Amgen yesterday. That was a very easy process. I just uploaded the EOB on my Amgen Support+ account. Now I just wait for them to add the money to the virtual card that they gave me.
thank you so much for this info.
Hope Evenity will work well for you, and that your doctor tracks your progress.
I, too have Medicare with an advantage plan. I pay a small OV fee of less than $35, however as Evenity is billed as an injectable it’s administered in a doc’s office so it doesn’t fall under Part D, unlike Tymlos where there’s the donut hole and MOOP to contend with. My monthly Evenity injections total just about $440 (x 12 doses). Seems like a lot until one considers the future costs of fracture risk: PT, X-rays and MRI’s, not to mention the pain, time, and loss of mobility associated with the fractures themselves. Might also be overall cheaper than Tymlos therapy. Cheers!
Have you read all the side effects of Evenity? Plus you can only take it for 1 year. You should look them up.
I’ve had bad leg pain from all the injectable bone builders so even if the drs’ are all over me to begin another med again. I’m done
Hi and Thanks, hopefullibrarian,
If you don't mind my asking, are you on Medicae?
Hi ashash,
I don't mind at all. I'm not on Medicare, I have commercial insurance.
I'm attaching a snippet of the EOB summary I received for my first set of injections, so everyone can get an idea of the full and negotiated prices. These numbers will vary based on your provider and your insurance. If you're paying a coinsurance, it will at least give you some idea of what your cost may be. My coinsurance is 50% until I reach the MOOP. I'm playing it safe using Amgen Support+ to pay until it runs out. If I encounter any side effects before then, I can quit treatment without having laid out much money. I'm only paying $25 per month at the moment with the assistance.
Thanks so much.
if I'm reading you correctly, looks like you"ll be responsible for around $1600?