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How do you halt the progress of osteoporosis?
Osteoporosis & Bone Health | Last Active: Dec 15, 2023 | Replies (148)Comment receiving replies
This is a long post regarding insurance and osteoporosis drugs:
I’m a social worker and my side hustle for 30 years was home health/hospice. The problem that came up the most with patients was drugs and paying for them. I learned the best way to help patients choose a Part D plan - call Medicare with patient and go over all of patients meds over the phone. The Medicare person on phone was generally polite and well trained. I even designed a form that we would use to enter all the information about each Part D plan. The patient could see which plan was best for them and sign up for it right then. This all is possible during open enrollment- October 15 through December 7. Now.
I no longer do this for patients as I retired from side gig (not from main job), but do this every year for my husband as he is on a zillion drugs.
Before i went on Medicare, I could not get my osteoporosis drugs covered. Now, I’m on traditional Medicare and it covered the astronomical cost of the Evenity that I am getting.
I have learned that traditional Medicare is always best for people with medical problems.
Meaning, not Medicare Advantage plans. You do save the cost of paying for a supplement if you go on an Advantage plan.
My and my husband’s supplement (combined) costs $290 monthly. Anyone who can afford this cost would benefit from choosing traditional Medicare.
As I used to tell my patients, with traditional Medicare you are using a plan that you’ve been paying into your entire life. Which is run by the federal government. With Medicare Advantage plans, you are dealing with an insurance company.
Advantage plans can change at any time.
Our supplements are through AARP. They publish a newsletter and a magazine which we receive. These contain a lot of useful information about drugs, insurance, research on drugs, how government is helping or not helping with cost of drugs, etc. I recommend these publications to anyone whether they choose AARP or another plan.
Best to everyone who is struggling to get osteo drugs covered. It’s ridiculously complex.
Replies to "This is a long post regarding insurance and osteoporosis drugs: I’m a social worker and my..."
Such a helpful and thorough explanation, thanks! I am not on any of these meds, at least not yet, but I do follow this discussion group due to having osteopenia. My late husband and I both had Medicare Advantage plans with our state teachers’ retirement boards. When his health issues became increasingly more complex - and when I discovered that a preferred rehab facility to which he may have needed to go didn’t have an agreement with our plan - I changed him to traditional Medicare and purchased a supplement. Even the rep at the retirement board stated that traditional was better for him due to his multiple issues and that was confirmed to me by a friend who is both a nurse and a social worker. I wish more people knew this! According to my endocrinologist, I may need one of these meds if I have to have spinal surgery at some point (before the surgery) so I am thinking that at some point soon I’ll make the switch.
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Susan,
I have the advantage plan and I am in the donut hole . I am paying $560. A month out of pocket for Evenity then when the new year starts it will go down until I reach the maximum again. It will only take a few months for that to happen due to the high cost of Evenity.
When you are on the traditional plan don’t you also reach the donut hole ?