Cost of Evenity injections

@marymj7 I don't know about whether Medicare Part B will pay if you delay your injections. I recommend you call Medicare and ask that question. I do know that I had to ask my prescribing physician to contact the infusion center where I get my injections when I needed to delay my injections beyond 30 days. Forty six days is a long time between injections. Have you discussed this with your prescribing physician?

Why wouldn’t Part B still cover the injections? Usually the infusion center clears it before they administer it.
I am shocked at the $14,000
price tag. Last year when I was having Evenity infusions, I could see on Medicare statement that the charge was $6,000+.

I don’t know how to get someone from medicare on the phone who can address this specific issue. The infusion center put me in contact with a drug rep who said as long as it’s no more than six weeks between shots I am considered to be in treatment. Sure hope he’s right

@marymj7 There is a phone number on the back of your Medicare card. On my card the phone number if 1-800-633-4227. Do you get your Medicare through an insurance company such as United or Humana? If yes, then you have a Medicare Advantage policy and you have to call that company. Again, the phone number if on the back of your insurance card.

I'll admit that Medicare representatives are not always helpful. Just like any private insurance company such as United or Blue Cross/Blue Shield Medicare is the funding source for your Evenity injections. Medicare "decides" what to pay and not pay. The drug representative can tell you what is recommended but they do not make the decision on payment.

Does anyone know whether Medicare Part B will still pay if I delay my October 7 shots until Oct. 22? That would increase the interval from my Sept. shots from 31 days to 46 days. I really need to delay but don't want to get hit with a $14,000 bill, which is what the infusion center charges. Thanks!

I don’t know how to get someone from medicare on the phone who can address this specific issue. The infusion center put me in contact with a drug rep who said as long as it’s no more than six weeks between shots I am considered to be in treatment. Sure hope he’s right

Evenity is two shots administered in the doctor's office and is covered by Medicare part B. Is your doctor suggesting it?

I read that Medicare only covers Evenity if you've already had a fracture. Do you know if they make exceptions to this? I have a Blue Cross Medicare Advantage plan, so maybe I need to call them. Thanks.

I read that Medicare only covers Evenity if you've already had a fracture. Do you know if they make exceptions to this? I have a Blue Cross Medicare Advantage plan, so maybe I need to call them. Thanks.

I would recommend calling Medicare. Also be sure you have Medicare Part B and not Medicare Advantage. And remember that if Medicare covers it under Part B, you will still have to pay the annual deductible and Medicare [original] only pays 80%. You'll want to find out what your Medigap insurance will pay.