Is a dexa every 2 years enough?

it’s very important to have a Dr you are comfortable with. However, I have been repeatedly informed that the most specialized osteoporosis drs base their decisions of what to prescribe factors including the severity of the T scores, the location of the the worst osteoporosis sites and alot of other diagnostic tests like the ones i had at the Hospital for Special Surgery in NYC. I would not have confidence that in three to four months on Evenity or Forteo that the ultimate effect of treatment could be determined—but that’s how my mind works. I’ve had the good fortune to have extraordinary physicians whose judgment i trust. With me, the issue is will i develop an auto-immune reaction severe enough to need to stop whatever treatment.

A totally separate topic but one of curiosity……has anyone here been successfully in getting their insurance company to approve switching say from forteo to eventity based upon bone marker tests?

It’s CHAT that i was referring to. And the resourcefulness and motivation of the various virtual customer service agents varies enormously. Some are very well informed and even provide excerpts of various Medicare regulations

Thank you for sharing your success upon appeal. For the first time, i have had a few claims denied as NOT medicallly necessary based upon the physician’s diagnosis. The other one was an ambulance denied as medically unecessary albeit i was in anaphylaxis/ The ER dr was “our to lunchL and wrote that a rash was the only type of allergic reactions i have rather than the veracity of anaphylactic reactions and auto-immune triggered afib. I would appreciate any pearls of wisdom you have for writing an appeal: thanks

I totally sympathize!
One additional thought for the claims rejected as not medically necessary: were you given an ABN (advance beneficiary notice) up front by the provider that identified the item and what you would be charged if denied? If not they may not be able to charge you based on their agreement with MC. Note that your generic agreement to pay all claims would not be sufficient to meet this requirement. May not be applicable, but if you did not receive an ABN I would call MC (or chat) to see.
On the emergency ER/ambulance issue, I have not had any luck trying to get health info from ambulance companies. I take it that the ER dr record was available had the incomplete description of your status. (1) Do you have access to your hospital records through a patient portal or something? If so check and see if there is anything there that might be helpful. Also is there anything in any billing detail that indicates the additional health issues? (2) Maybe a doctor that provided follow on care can help provide the missing info.
Good luck!

my insurance appeal info states that it’s the patient who needs to appeal. And if the dr doesn’t believe that coverage will be extended—then i am required to file a form accepting medical responsibility

@hopefulheart I realize this discussion is months old but it hits on one of my personal peeves so I'm going to thrown in my two cents anyway.
So DXA every two years is often stated as if that is the golden rule. It is in fact idiotic in many situations and I believe a third grader could easily handle the math and logic. You take Evenity for one year. If you do not have a DXA close to the start date and close to the end date then you do not know what you accomplished with that year of your life and and a years exposure to a powerful drug.
If you finish Evenity and do not get a DXA and start Reclast or Prolia or anything else and then a year or two later you get a DXA you will not know what each of those drugs accomplished or failed to accomplish in improving your bone density. At that point you do not have the valuable information that you could have had with before and after DXAs for each of these drugs. Knowing your gains, losses or breaking even on each of the drugs you used enables you to make future decisions based on how these drugs work for you. What if most of your gains came from the follow up Prolia and not Evenity. Would you take Evenity again? What if you gained 25% in your LS with Evenity but after a year of Reclast only 12% was left? Would you continue to rely on Reclast to save the day? Those are extreme examples perhaps but not everyone has the same reaction and benefits from these drugs so you need to know what your reaction - your personal benefits to any of these drugs are.
As I said - just plain idiotic.

Completely agree!

Well said and totally agree with you. If i did not have to wait every two years for a DEXA score, i may have caught the osteoporosis in my left hip after taking Reclast for 6 years. So now, my endo wants me to go on Prolia. Never had a problem with Reclast but what i read about Prolia concerns me. Any one have good results and no side effects on Prolia?

Note the part that everyone seems to ignore. Medicare does cover more often than once every 2 years.

"Medicare Part B (Medical Insurance) covers this test once every 24 months (or more often if medically necessary) if you meet one or more of these conditions:

You’re a woman whose doctor determines you’re estrogen-deficient and at risk for osteoporosis, based on your medical history and other findings.

Your X-rays show possible osteoporosis, osteopenia, or vertebral fractures.

You’re taking prednisone or steroid-type drugs or are planning to begin this treatment.

You’ve been diagnosed with primary hyperparathyroidism.

You’re being monitored to see if your osteoporosis drug therapy is working."

@susanjane77 Hi. Before commenting on Prolia I want to say that generally you don't want to be on Reclast 6 years consecutively. That's too long to have heavy duty bone suppression. I don't know your details and all your DXA scores and how that's trending and so on but I personally would be thinking of taking an anabolic (bone building) med after all those years of bone suppression. My idea and hope is that a bone builder following a bone suppressive med may at least somewhat restore the architecture and bone quality that will have declined with long term bone suppressive meds.

On Prolia, lots of people have good results and few or no side effects with Prolia. The biggest problem comes with how to stop Prolia if you need to stop taking it. The longer you take it the greater the danger stopping it. When you stop you lose all the bone you gained while taking it and the loss occurs rapidly. That will happen to everyone unless they take some other med to stop that loss and even a follow up drug may not stop that loss.

But worse than that is that some people get multiple fractures on stopping. So they don't just lose the bone they gained, they start fracturing and may fracture many times. I don't know what percentage of people this happens to, I wish I did. I've seen on these groups people saying they got 2-10 fractures within a year or two of stopping Prolia. This happens most often when doctors are or were unaware of this problem.
So Prolia works great for many people but some of us think this is a drug that is a reasonable choice only quite late in life. When you don't expect to live more that 6-10 years say.
That's a very quick run down of the worst issues. Others will have different opinions to consider.
I have no medical training - I'm just a guy trying to turn my own bone loss around.