← Return to Evenity and Medicare - What do plans cover and how much?

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@babs10

@berniebrooks3, As someone else mentioned, you have to get the injections in an infusion center. Before my scheduled start date, I was able to confirm that these treatments would be covered at 100%. (I didn't end up starting, but I got the info I was seeking). Good luck!

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Replies to "@berniebrooks3, As someone else mentioned, you have to get the injections in an infusion center. Before..."

My personal experience . . .

Tymlos is administered personally at home, partially covered with a Part D co-pay. Evenity is administered in a doc’s office, again with a co-pay. Reclast is administered in an infusion center and, as I remember, there was no co-pay.

I’m glad to hear some of us are receiving these treatments with zero out-of-pocket dollars as the costs can really add up. At least with Tymlos, once the Part D coverage reaches the “donut hole” the price goes wayyyy down. For Evenity, the monthly co-pay was not horrible and remained steady throughout the treatment.

I don’t know the criteria as far as previous frax, etc for whether or not that affects the costs. I questioned the insurance company about the validity of Evenity being a “medical service” and not a script and was told I was billed correctly.

Cheers, all!