Hi babs10. Sorry it's taken me so long to get back to you.

The way my Medicare AARP UHC Plan D works for Forteo is:
Deductible phase: I pay the full cost of Forteo up to the deductible (which is $545), then I'm kicked into the Initial phase.

Initial phase: I pay a copay (or coinsurance) and the plan pays the rest. Net, my copay and what the plan pays together go towards the $5030 donut hole. Then I'm kicked into the Coverage Gap phase (or Donut Hole).

Coverage Gap Phase (Donut Hole): I pay 25% of the total cost until I reach $8000 (or Catastrophic Phase). Then I'm kicked into Catastrophic Phase.

Catastrophic Phase: I pay $0 cost.

For me I'm paying roughly $3327 full year for the cost . My plan payment by month will be April ($1550), May ($1166), June ($610), July-Dec ($0). Forteo is so expensive (retail $4633/mo) that I only pay out of pocket for the first three months.

I should note that my $3327 full year cost does not include pharmacy administrative fees or needles. I don't know what that cost is yet.

Yes, this is still expensive, however, I don't qualify for the various discounts through the manufacturer or other. After reading this string of comments from others, I will see if my doctor's office can provide any assistance with a better plan/cost. Thank you to everyone else for that insight!

If you haven't already done this, you should go to either Medicare.gov or your Plan D Anthem BC/BS and they should have an tool that will break this out based on your plan.

Just fyi, if I remember correctly, under the Inflammation Act signed by Biden, the Catastrophic Phase will be $2000 in 2025. Again, if I understand this correctly, all our out-of-pocket drug costs will be capped at $2000, then we pay $0. I may be wrong. I hope not (:->). But who knows what will happen in an election year.

I hope this helped.