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Question about Evenity and insurance (non-Medicare): if it's administered at the doctor's office, it's a medical claim, I know. But, how would I know how it is priced? I know what a normal doctor visit costs, and if the doctor does additional tests, but I have no idea how an injection would be priced. If Evenity is not in the plan's formulary, does that mean the doctor would not get paid for doing an injection?

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Replies to "Question about Evenity and insurance (non-Medicare): if it's administered at the doctor's office, it's a medical..."

@njx58

Have you checked with the medical billing department at your docs office?

@njx58
I posted what I just went through…on another post. There is more that can be done than I ever knew about …I think they want it that way but certain wording can really help…
Medical necessity or urgent your t scores much more a signed letter from your doctor…

@njx58
I actually just got a call today from my doctor's office telling me that my insurance is covering the Evenity injections. I only have a copay. The copay is the same as I pay for doctor visits-$45.