Evenity and Medicare - What do plans cover and how much?

I was told I would pay 20%. I have a BC/BS Medicare Advantage Plan.

The copay for my first Evenity injection was $791.68. I have SCAN Medicare advantage plan. I was directed to investigate a copay card with the manufacturer. I didn’t qualify for help there. They directed me to PAN, an organization that can help with copays. PAN help is grant-based. When the organization runs out of funds in that section, they close it. It was closed when I attempted to complete the forms.
My second injection is scheduled for 5/22. We will see what surprises await.

That is what Amgen told me in 2021 when I looked into Evenity: they have funds from foundations that run out. Ugh!

I pay almost nothing for my Evenity injections! You are being ripped off.
Because the injections are done in the doctor’s office, it’s not covered under Medicare part D but part B. For God’s sake, stop and get this corrected! Never get Medicare Advantage. It’s just private insurance for seniors rather than the original - and better - Medicare.

I pay almost nothing for Evenity under Medicare Part B. Do Not Get a Medicare Advantage Plan. They are simply private insurance for seniors. With regular Medicare and a supplemental plan you have much better, less overall costs and more reliable insurance.

@solveigsp half of Americans over 65 are on Medicare Advantage plans and some of us love ours. We still get covered by Medicare B. You may have a relatively high cost supplement if you paid nothing for Evenity. Advantage plans are free or low cost so it evens out. And mine has a good cap on out of pocket expenses. I went to 4 hospital financial counselors and they all recommended an Advantage plan. It may be different in different states, I have no idea. Pardon the tangent!

The reason so many people sign up for Medicare Advantage is because of their constant advertising and telemarketing. Most people do not understand that traditional Medicare is a government program and Medicare Advantage is private insurance with all its pitfalls. I taught Social Welfare History to my college undergrads and graduate students, which required me to learn more about Social Security and Medicare than most people know. I am opposed to private insurance because it’s all about profit instead of patient care.
From Investopedia -
“ You will find that many plans unexpectedly won't cover certain expenses when you get sick—resulting in unforeseen out-of-pocket costs for you—and what they pay can differ depending upon your overall health.”
https://www.investopedia.com/articles/personal-finance/010816/pitfalls-medicare-advantage-plans.asp

Hello, Without insurance, it is very, very expensive. Figure between $1400-1800 per month for 12 months.

I don't own a tv 🙂 As I said, 4 financial counselors suggested my plan and one is on it herself. I have a lot of medical problems and use several hospital systems and have not had any problems.

It varies, from what I gather, from state to state and company to company. I prefer a private company to the government myself.

Since I have more than 5 conditions, my plan provides home visits and check in, free therapy, mobile blood draw and x-ray at home. Dental, vision and hearing are included. I pay $79 total per month.

And we still have Medicare B coverage.

My explanation of benefits showed Evenity, retail of $8,000 for each visit.
Medicare plan B payed 80% until the deductable was to be met, leaving me $345 a month. Evenity has no co-pay plan and so I switched to Prolia.