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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
If you are not 65 then are you on Medicare for special condition or are you on Medicaid? Will insurance companies be required to accept you during the initial enrollment period if you are already on Medicare now as you would not be the typical person enrolling at age 65. Advantage plans have a network of doctors, to go outside that network is to pay out of pocket. And not all clinics take Advantage Plans...for example Florida and Arizona Mayo don't. In Minnesota some insurance companies have made a deal with Mayo to have Mayo in their network. But every year networks change.
https://www.investopedia.com/articles/personal-finance/010816/pitfalls-medicare-advantage-plans.asp.
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@vic83 I fully agree that there are disadvantages to to an advantage plan. Yes I have Medicare because of a medical condition (quadriplegia) since 2012. In the beginning no one under 65 could get any sort of medigap policy. A few years ago they changed the law requiring companies to offer medigap policies, but they didn’t go far enough in specifying the types or costs. I have lived in Virginia and Maryland. Both states only offer plan A, which is the most basic plan. Every year I do my due diligence and get a price quote from the few companies that offer it. My quotes this year, similar to those in the past, were in the $2000-2500 / month range. So I am much better off with an advantage plan.
John’s Hopkins offers a variety of advantage plans, so every doc at Hopkins is in network. I feel my needs are being met without going out of network as of now.
I do worry that when I turn 65 there will be an increase in my medigap premium since I didn’t enroll immediately. But I don’t let it turn into anxiety or overly worry about it as there is nothing I can do except write my representatives in congress which I do every few years. One year I actually got a response from mark warner (Virginia senator) himself, not just one of his subordinates, as i usually get.