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@susanfalcon52

I am on Evenity and seem to have no side effects. I have traditional Medicare and it is covered 100% under Part B because I have the injections at an infusion center.
Other non-traditional Medicare plans like Medicare Advantage plans are different. They seem to all have different rules about these drugs.
Open enrollment starts October 15 and you can change Part D plans then if you want.
I have never changed my plan because the Part D plan that I have is fine. Also, the Evenity is covered by Part B. Every year, however, I call Medicare - 1-800-med-icar- and review my husband’s Part D plan. He is on a lot of expensive drugs and the formulary changes year to year. This is a project, but important.
I call Medicare during open enrollment and the well trained, helpful person on the phone already knows what drugs he’s on, where he’s getting them, how much they cost, etc. They will then look at other plans with me and we figure out what is best for the coming year. If he changes plans, the Medicare rep on the phone can do that right then.
I have been doing this for 20 years for seniors on Medicare. Now I’m a senior and vigilant about this.
Just remember that the Part D plans are all private entities, therefore, they have a profit motive. Medicare is not for profit and doesn’t care what plan you choose. So, you will get unbiased information from them.

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Replies to "I am on Evenity and seem to have no side effects. I have traditional Medicare and..."

Thank you Susan
I had not thought about calling Medicare directly.

I have traditional Medicare with a Part D drug plan.
The Part D drug plan denied Evenity coverage. I appealed the decision twice and it was still denied. Can you explain if your doctor orders the Evenity and bills it as part of the treatment plan to Medicare Part B?
I am currently on Forteo with some positive results but have been on it over two years. It was authorized for a third year for some people. I have no side effects. The Part D drug plan picks up most of the costs after the deductible is met which still leaves me with covering alot of the costs. Was on Bisphosphates for 15 years with increasingly worse bone density.
Any advice re getting Evenity covered would be much appreciated.
Nancy