What Osteoporosis medicines are likely to be approved

Posted by stoltzks1956 @stoltzks1956, Dec 18, 2025

I am needing Osteoporosis meds now. I understand it is hard to get approved for any osteoporosis meds from insurance. I have looked on the company’s websites and I won’t qualify for their discount because I have Medicare. I will not be able to pay for any on my own. Anyone have suggestions on how to proceed.?

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

Profile picture for rjd @rjd

My experience has been that 'SHIPS' can be either really helpful or not. Depends on the state and the resources it puts into this program. But it is a good first effort.

There are many programs for help with medical assistance if your income is below certain thresholds. Medicaid would likely be the most helpful but there are also other income-based programs available for Medicare enrollees. But you have to learn about them.

The place I would go to for counseling assistance if I became stymied is the Medicare Rights Center 800-333-4114, which does not charge a fee like a private advocacy business. Best of luck.

Jump to this post

@rjd I’m adding that to my contacts rn, thanks!

REPLY

Generic Forteo(Teraparatide) has been covered after I reach my deductible. $1300 for first prescription, then no cost soon after that. I have Well Care insurance. Good luck!

REPLY
Profile picture for cbusgma2017 @cbusgma2017

@njx58
Yes, if you get a Medicare Part D drug plan that includes the medication, your out-of-pocket cost for your drugs is limited to $2100 for the calendar year. But the cost of Part D plans that include Tymlos is considerably higher than other plans. For example in my area (central Ohio), there was only one plan this year that included Tymlos, and it was $123/month (this as compared to $7/month for a plan that included all my other drugs but not Tymlos). So the $2100 cap helps but doesn't necessarily tell your total cost.

Jump to this post

@cbusgma2017 I have WellCare Part D. Monthly cost low and i take Tymlos. My Endo is who got it accepted.
Also what others should know is you do not need to pay thr $2100 upfront at first. If you will contact Medicare you can get on Express Scripts and payments are monthly. Easy to do over phone. Walgreens gave me who to call.

REPLY
Profile picture for yvettenie @yvettenie

Generic Forteo(Teraparatide) has been covered after I reach my deductible. $1300 for first prescription, then no cost soon after that. I have Well Care insurance. Good luck!

Jump to this post

@yvettenie I have WellCare too. I subscribed to Medicare express scripts and no huge upfront first payment. They let you pay in out monthly.

REPLY
Please sign in or register to post a reply.