Evenity and Medicare drug coverage

Posted by lbtw @lbtw, Jun 2 2:43pm

I don’t know if any of you can offer a suggestion — but thought I’d give this group a try. I just started Evenity this past week and it is covered by my current insurance. In August I will be on Medicare and I’m trying to find a drug plan - part D - as I research them — none cover Evenity — with a 17,000+$ cost. Any suggestions. Thanks in advance

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I paid $0.00. Medicare paid $5,000+

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@hopefulheart

So did you pay $5,000
Or were you saying that was the individual injection cost to Medicare?

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I was researching drug coverage — I will be on Medicare soon — I mistaken thought it was under part d but it’s covered under part b — so no problem on coverage.

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@hopefulheart

So did you pay $5,000
Or were you saying that was the individual injection cost to Medicare?

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I paid $0.00. Medicare paid $5,000+.

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@naturegirl5

@lbtw I have Traditional Medicare. Evenity is covered under Part B however I have to go to a clinic with an Infusion Center to get my injections. In order to Evenity to be covered I could not get the injections at my PCP (primary care provider) office.

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Did Medicare cover it all because mine said it doesn’t?

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@jolie2525 I have Traditional Medicare. I received my Evenity injections at an infusion center. This is a Part B designation as outpatient medical and the injections were administered by the infusion center's nurses. My Evenity injections were completely covered (at $5000/month!). When my endocrinologist prescribed Evenity he told me that I would have to go to an infusion center at a medical center/hospital for these injections. He said this is not a Part D prescription designation.

If you have a Medicare Advantage Plan (which is not Traditional Medicare) then your planjolie2525 I have Traditional Medicare. I received my Evenity injections at an infusion center. This is a Part B designation as outpatient medical and the injections were administered by the infusion center's nurses. My Evenity injections were completely covered (at $5000/month!). When my endocrinologist prescribed Evenity he told me that I would have to go to an infusion center at a medical center/hospital for these injections. He said this is not a Part D prescription designation.

If you have a Medicare Advantage Plan (which is not Traditional Medicare) then your plan is administered by the insurance company that you signed up with such as United Health Care or Blue Cross/Blue Shield. to administer your Medicare. If you called your insurance company and they said Evenity is not covered then I suggest you call them again and tell them that Part B does pay for Evenity and that since Traditional Medicare covers this under Part B they are required to do the same.

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Thank You so much for your help. I did speak with someone at my insurance company and they said they only covered 80% and my responsibility is &545 a month but can’t afford that. Maybe it’s because Aetna in Florida doesn’t cover it?

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