Drug coverage

Posted by jjjjjjjjjj @jjjjjjjjjj, Sep 19 3:28pm

My insurance considers Tymlos as forteo a “specialty” drug and won’t cover them. My Mom has Medicare blue preferred and they won’t cover the drugs either. How do people pay for these medications. They run about 4 grand a month! Help.

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This is greatly helpful information. It's still early in Tymlos treatment. Not sure what doctor will prescribe when the 2-yr Tymlos duration expires and whether or not insurance will cover new medication. Thus far, my private insurance covers most of the monthly cost for Tymlos (without insurance it's $3K/month). Information presented gives me food for thought and like Arnold Schwarzenegger "I'll be back!" 🙂 on this chat in another 13 months if I encounter any insurance difficulty. Thank you to all who offer suggestions for accessing pricey medication. It's good to know we are not alone in our struggle to access coverage for medication.

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51% of denied pharmaceutical requests were overturned on appeal.

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@gently That a good bit of Info! Very useful!

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