@guinivere

My Medicare Advantage Plan covered Tymlos as a tier-5 script that fell under prescription drug coverage . . . in and out of the “gap” and ending as a very small co-pay by around July/August. As Evenity is injected in a doc’s office or clinic, the procedure code is different (sorry, I can’t remember the insurance terminology, but it falls under something like “medical services”) and is billed at about the same amount each of the 12 months, so I knew what to expect. Prolia may be billed the same way as Evenity as it is administered in a doc’s office.

You can call BC/BS and ask them what your co-pay would be if you have an advantage plan. The first six months of Tymlos, for me anyway, was every expensive - there are subsidies from other sources to assist if you qualify - I had a pharmacy team member just about in tears telling me how much my co-pay would be.

Bottom line is make the call to BC/BS and ask them what they estimate your costs will be; they should be able to give you some idea even if the amount changes due to the contract purchase price and what your insurance will cover. They may also be able to help to see if you qualify for any of the subsidies.

Best wishes to you as you continue through this process. Cheers!