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Evenity and Medicare - What do plans cover and how much?
Osteoporosis & Bone Health | Last Active: Dec 4 8:56am | Replies (129)Comment receiving replies
Just completed my second shot of Evenity.
Received an invoice showing charges for Feb. I have Medicare Advantage plan through Wellcare. The invoice showed that the injections totalled approx $8,000. After processed through ins. my coat was $345.
After spending an hour and a half on the phone w/ins.,. The conclusion was that every month I would be responsible for $345 each month until my deductable had been met.
They pay 80/20 until deductable is met. Then they pay at 100%.
Your deductable will be different with each insurance co.
My shots are not at the PCC's office.
It is at an infusion office. (Specialist)
I can't afford this each month and am looking for a different avenue. But, hope this clarifies how the system works with Medicare. Yes it covers 80% until your deductable is met and then covers 100%.
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Medicare Advantage is NOT traditional MEDICARE. Medicare Advantage is private insurance company with a Medicare connection. Depending on who your insurance company is will vary as to costs.
Traditional MEDICARE is national and the same everywhere. No referrals are needed. They pay 80% and any supplemental insurance ( mine is AARP) covers the 20% of health care and hospital costs.
Injectables have a unique place in all of this. So best to check it out with your Evenity provider in line with your Medicare or Medicare Advantage plan as they could be quite different.