Payment for Prolia with Medicare

Posted by dna41 @dna41, Aug 12, 2023

Not sure if this is an appropriate question for this site but here goes. I have taken Prolia for a few years and Medicare Part B paid for it. Now my doctor said they have lost their Prolia supplier and will have to use my Part D insurance to pay for it. That will require me to pay over $2000 per year that I didn't pay in the past. My question is, has anyone been able to bill Medicare directly for Prolia cost (as an individual)?

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AARP Medicare Advantage through United Healthcare Does Not Cover Prolia in Pima County, Arizona.

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Also interested. Following your post.

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@1956slk

AARP Medicare Advantage through United Healthcare Does Not Cover Prolia in Pima County, Arizona.

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I don't know what Advantage plans offer, but Medicare will pay for Prolia and, I believe, Reclast.

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My suspicion is that you'll need to change physicians. Or with original medicare, you can easily add an extra physician for the twice a year injection.

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@dna41

I don't know what Advantage plans offer, but Medicare will pay for Prolia and, I believe, Reclast.

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All I know is that the advantage plan is awful. I am considering changing plans to a supplemental plan. We had to do that with my husband when the advantage plan would not pay for a surgery when the other plan did..

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