@taraneh64 My doc would need to appeal to Maryland Medicaid and to Medicare, that's what pays for all for my medical care. And yeah, that rationale for starting with an anabolic makes sense and has some research behind it. Insurance companies of course are just about the money. I think I basically won't take a Bisphosphonate at this point even though the hip score especially is severe. It's hard, choosing between two possibly lousy and also unknown outcomes. I did text the very good Osteo PA in the portal just to ask if she would consider starting with Tymlos or Fortio, she's not pushy and gets the concern, anyway. She'll probably respond tomorrow. Thanks so much for your reply!