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Medicare Advantage Coverage of Evenity

Osteoporosis & Bone Health | Last Active: May 22, 2023 | Replies (5)

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@johnbishop

Hi @bellagila, I know it's frustrating when your health plan insurance gets switched. I went through a similar change this year and found out that the best thing you can do is call the insurance company and talk to them about your concern. I found a frequently asked questions document on your upcoming plan that might be helpful. Here are two of the FAQs listed in the document linked below.

"How do I know if my drug is covered?

The formulary (list of covered drugs) is Comprehensive+, an open formulary which means that all Medicare Part D drugs are covered. To check if your drugs are covered or estimate the cost of the drugs you are taking, visit our website at CONY.AetnaMedicare.com

I’m currently taking a drug that requires a prior authorization (PA) every year. How do I know
if the drug is covered and how much is the cost?

All Medicare Part D drugs are covered under the Comprehensive+ formulary. However, if the drug you are taking requires a prior authorization, the plan will cover up to a 30-day supply in the first 90 days of when the plan starts as a transition of care fill. After your first fill, we will notify you and your doctor to submit a prior authorization. If you need assistance or have questions, call the number on your prescription drug member ID card."
--- City of New York Aetna Medicare Advantage PPO plan: https://www.nyc.gov/assets/olr/downloads/pdf/health/aetna-ma-docs/cny-0029-faqs-print-single-pages-final.pdf

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Replies to "Hi @bellagila, I know it's frustrating when your health plan insurance gets switched. I went through..."

Use John's action plan first! He has established a path for you, use it.