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Prescribed Tymlos after Evenity
Osteoporosis & Bone Health | Last Active: 41 minutes ago | Replies (21)Comment receiving replies
@windyshores Thank you so much for your reply. To answer your question, changing my insurance plan won't help as the doctor who prescribed Tymlos doesn't take Medicare at all. I will contact his office today to find out what private pay will cost. I can also contact the infusion center where I received Evenity as they accept my insurance and find out if any of their affiliated doctors are familiar with using Tymlos after Evenity. The concern regarding doing so is that patients will have an increased risk of osteonecrosis/osteosarcoma, but that is conjecture as there aren't any studies available. I will certainly let you know what I find out!
Replies to "@windyshores Thank you so much for your reply. To answer your question, changing my insurance plan..."
@hollygs I was curious about the rules around doctor’s not taking Medicare as I am on Medicare, too. Looks like your doctor will have to create a contract with you before providing services that says neither of you will bill Medicare, if he opted out of providing Medicare reimbursed services.
Here’s a good link explaining it all. This site provides directives for the doctor, telling them what they can or cannot do.
You have to scroll down the web page to find the section on Opt Out Of Medicare.
https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/chain-ownership-system-pecos/manage-your-enrollment#:~:text=Physicians%20and%20practitioners%20who%20see,the%20CMS%20Opt%2DOut%20Dataset
hollygs, I wonder if the (we have to say dilligent) doctor who worried about Tymlos after Evenity would be assuaged by information that the black box warning against Tymlos and osteosarcoma has been removed.
Tymlos is prescribed to aid in the recovery from osteonecrosis.
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Has your doctor filed an "opt-out" request with Medicare? If so, your Part D drug coverage can still be used.