Cost of Evenity injections

Posted by shula @shula, Jun 17, 2023

Does anyone know what is the out of pocket cost for Evenity if one has traditional Medicare with a supplement vs Medicare advantage program?
I was told by Aetna Medicare Advantage CONY the the out of pocket cost is $602.89
for each injection visit. They said Evenity is a tier V medication. I heard Medicare part B covers 80% and Medigap or supplement covers 20%. However I think the out of pocket cost for every Evenity visit would be costly.. appreciate a reply and thanks. Shula

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

Profile picture for Helen, Volunteer Mentor @naturegirl5

@patwerthman I have Traditional Medicare. I received my injections at an infusion center and Part A and B paid for all the costs. I never have a co-pay with Traditional Medicare. They either pay for some procedure or they do not. By the way, I also have a Part G Supplemental Plan that I pay for. This Part G fills in the gaps not covered by Part B of Traditional Medicare.

If a person has an Advantage Plan (sometimes called Medicare Advantage) then the insurance company is a private company that contracts with Medicare. Medicare Advantage may or may not pay for Evenity.

Jump to this post

@naturegirl5 good to know. And check on before this occurs for me. Thank you

REPLY

The Medicare supplement Plan G only covers the remaining 20% for whatever Medicare paid 80%. If Medicare didn't cover it at all, then the supplement plan won't cover it either. Initially I was confused about this. I thought the supplement plan would cover something that Medicare denied and that's not accurate.

REPLY
Please sign in or register to post a reply.