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Back on Evenity via Infusion Center in Hospital
My former Rheumatologist stopped working with my insurance company and would now only accept the drug coverage (very, very expensive this way) and not the medical coverage. I went through my PPO for help and am now going to a local hospital infusion center which is almost half the amount being applied to out of pocket expenses not drug coverage. I am on a Medicare Advantage HMO plan. Going through a hospital is such a different experience! Each time I go, I have to register. Once registered, I then go to the infusion center who then puts in an order for the medication. Once order approved, I get my shots. Afterward, my PPO needs to get an approval for my next shot. Once that is done, I then can make my next appointment. Has anyone had a different experience going through an infusion center? Much different than going through the Rheumatologist’s infusion center.
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Sorry to hear you have to go through all of that. I’m on Evenity too and need to go to an infusion center at our local hospital. I need to register before I can go up to the second floor but that’s just to make sure my information on file has not change. I’m on Medicare and have my supplement through AMA and they have covered all costs of my treatment so far.
My experience: I previously had multiple doses of Reclast in an infusion center (hospital and clinic) and except for a few bucks, the cost was covered.
I also had Tymlos, self-administered, which fell under Part D of Medicare, and cost a small fortune until dropping into the gap (donut hole) and back out the other side. I no sooner had the costs for Tymlos under control when my body began to “reject” Tymlos and I had to discontinue it.
Fast forward to Evenity, and here’s the important part, it was not covered under Part D, because it was injected by my doc’s nurse, not at home, and not in an infusion center. It is not billed as medication, but rather a medical service and is billed completely differently. I fault my rheumatologist for this!! He likely could’ve prescribed the same meds to be given in an infusion center and the cost would’ve been manageable; I found out too late. Since finishing Evenity injections, I had Reclast (in July 2024) and the cost was again covered.
Here’s to making it work! GO ELGSES!
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1 Reaction@beanieone Could you please tell me what you experienced when your body began to reject Tymlos? I am almost done with my 2-year course, and the past month, my side effects (mostly nausea) have become more severe.
Hi @bayhorse
As nausea seems to be your number one issue, I’ll not bore you with the myriad of other issues I had.
My nausea started very early in my treatment and continued, I think every day, until I stopped taking Tymlos. I tried ondansetron (Zofran) to help with the nausea, but it didn’t even take the edge off. My doc found it incredible that ondansetron didn’t stop the nausea as it blocks the body’s ability to feel that sensation. I went back to the old remedies: Peppermint candies and crackers which might have been as good or better than meds.
I’m sorry to hear that you’re experiencing this problem. If it gives you any comfort at all, my stomach problems dissipated almost immediately upon discontinuing the Tymlos. As you are almost at the end of your treatment, I think you’ll likely get relief pretty quickly thereafter.
If I can help you with additional information (or info about other reactions, etc) please feel free to reach out.
Cheers!
Hi@beanieone, and thanks for your reply to me. Glad to hear the nausea stopped after you stopped the Tymlos. I, too, tried zofran to no avail, so you have both my sympathy and empathy. Would you mind telling me what other side effects you experienced on Tymlos? I have a variety of autoimmune illnesses as well as osteoporosis and spinal stenosis, so when a new symptom shows up, I'm hard pressed to figure out if it's a drug reaction or yet just another "blessing" my body has bestowed on me. 🙂 It might help me to compare with your experience.