I think, and I could certainly be wrong, if you have Medicare, you cannot use the discount coupons.
Usually Medicare pays first, whatever their portion is. Then your supplemental coverage picks up whatever their portion is. Then you pay the rest until you have met your deductible.
These posts mention Blue Shield and Aetna so they may pick up the entire cost minus your co-pay to start?? Then when you go on Medicare, Medicare will pay their portion first then your supplemental coverage will pay their portion, then you pay your deductible. No matter which route you go...coupons, insurance coverage, out of pocket or Medicare, I don't think you would have to pay the full amount......Lets hope.
I don't think this is one of the Medicare drugs that is being cost negotiated. Most of those are more common and taken by large groups of patients. TYMLOS is not a well-known, highly prescribed medication yet.
During a hospital stay and two different doctors visits, I was asked for a list of my medications. All three asked "what is TYMLOS" Now I save the information that comes every month with my Pen so that all my doctors have it in my records.