Cost of Evenity injections

It may depend on your Medigap plan but I was told when I asked that there would be no out of pocket cost for me. I have plan F.

I have a BC/BS Medicare Advantage Plan and will pay 20% until I hit the donut hole. Amgen, the manufacturer, does not have a patient assistance program but they have some foundations that sometimes help. You can call Amgen.

I thought the donut hole is for Medicare part D plan. Evenity is billed under Medicare part B plan.
I do not think the donut hole applies when a medication is administered in a doctor’s office. It does not qualify as a prescription medication. That is my understanding. Thanks for your reply.

I have medicare & aetna supplemental. Only had to pay my deductible.

I can not find my copy of Medicare and You 2023 but did find older versions. There us a tabl

There is a table in each showing what the plans will pay for Part B. Most plans cover 100%. Some have deductibles while others do not.

I think that the Aetna Medicare Advantage CONY (City or NY) which is a new plan will not pay the 20% supplement. This is a Medicare C plan. This is my concern right now. The high cost of each visit for Evenity.
I am wondering if anyone has medicare advantage insurance and if they cover the 20% cost of the visit.
Thanks.

As I wrote, my Medicare Advantage Plan does not pay the 20%. I pay it. @shula you may be right about the donut hole: I have to check on that.

I would call Amgen to see what financial assistance might be possible. The foundation help apparently varies throughout the year.

AARP MEDICARE THROUGH UNITED HEALTHCARE does not pay either. I don't think they pay for any injections. So I won't be getting it.

Thanks for your reply. Do you have AARP UHC advantage program or traditional Medicare with part A and B?
I note that a few people said their part B covers the cost for the injections with traditional Medicare.
Shula