I am in the exact same boat with Medicare Part D. I make just over the Tymlos financial cut off for any assistance. I basically had to make the difficult decision, knowing that I would be paying the $2,100 out of pocket max each calendar year to remain on the medication. Sadly, that's means paying for the first pen and a half, before it becomes free for the rest of that calendar year. For me, the gamble was my high chance of side effects and not being able to stay on the medication beyond the first pen or two. That is still yet to be determined. At the end of the day, I could not afford to not pay the big money out of pocket. I had to prioritize my bone health first. At the end of this journey, I am hoping to have as few regrets as possible.

Also, if you have not tried Evenity, you could possibly look into that as it is both an osteoclast and osteoblast and is processed through Part B. Based on your insurance plan, Evenity might be more financially practical.