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Forced to switch to biosimliar of Prolia by local provider clinic
Osteoporosis & Bone Health | Last Active: Dec 25, 2025 | Replies (21)Comment receiving replies
Are you on Medicare yet? Actually, a Medicare Advantage plan (Medicare Part C) restricts people on choice of doctor, treatment, and medications. One has less choice than with Traditional Medicare (Part A/hospital, B/visits&tests ad D/drugs). I am grateful I chose Traditional Medicare and I could therefore self-refer myself to Mayo Clinic when my lung issues started. I went from an abnormal chest x-ray to lung cancer surgery in only 7 weeks! And no bills. That would never have happened with an Advantage Plan!!! The Mayo Oncology dept has a sign/brochure about what to do if your insurance refuses to cover your cancer treatment.
Returning to the Prolia issue, the local clinic decided to NOT provide for their financial reasons. I HAVE COVERAGE but I need to go to a different organization. It is a Part B drug and should be administered in Dr's office for coverage under Part B. Otherwise it will be much more expensive if I would purchase it under a Part D plan.
Replies to "Are you on Medicare yet? Actually, a Medicare Advantage plan (Medicare Part C) restricts people on..."
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I am not judging on the appropriate plan to be on for a particular person or groups of people, I am just informing those who have Medicare part C, an advantage plan, do not have part D, and the rules are different. With a part C advantage plan, one can get their routine vaccinations at a pharmacy or at their doctors offices. I prefer to have it done at my doctors office, it’s just one less thing to worry about, as it’s in my records, I don’t have to inform them. I agree there are many good reasons to stick with traditional Medicare, especially if you have a medigap supplemental policy. I am under 65, so the medigap annual premium is outrageous high. When I turn 65, I will switch to traditional Medicare with a medigap policy