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Starting Tymlos..

Osteoporosis & Bone Health | Last Active: Jul 18 7:44pm | Replies (24)

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Profile picture for njx58 @njx58

@zambezifalls Every Part D insurer has their own formulary. You'd have to check if they cover Tymlos or Forteo (or generic Forteo.) They are certainly going to need a prior authorization form from the doctor.

I had to switch Part D plans two years ago because Wellcare dropped Tymlos from the formulary. You can use medicare.gov to look up plans that cover these meds.

Even with coverage, you'll be on the hook for the Part D OOP cap, which is $2100. That doesn't even cover one month of Tymlos.

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Replies to "@zambezifalls Every Part D insurer has their own formulary. You'd have to check if they cover..."

@njx58 I was in a similar situation. I waited until a new year started so I could switch my D coverage. In my area the only company that included tymlos in formulary was UHC. Unfortunately they also have a high monthly premium. I will be done with tymlos end of this year and plan to switch companies based on whatever drug I move to.