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The insurance process for Forteo & Tymlos
I have had fairly bad osteoporosis for quite a while now due & have been ditering back & forth on what to do. Have finally decided on either Foreto or Tymlos. I have applied for ffnancal help from the Univ of Wisconsin where my endocrinologist is but today was told that would take MANY months!! On reading the sites for both Forteo & Tymlos, it looks as tho both of them offer the means for financial help.
Has anyone gone this route & if so please let me know!!!!
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@guinevere, I got free Tymlos for 18 months. From Radius Assist. Looks like they are now providing 2 years. Read this entire link:
https://radiuspharm.com/radius-assist/
There is a telephone prescreening, which your provider can do, or you . Household income has to be less than 300% of the federal poverty level. It says that during prescreening, if your income is higher, they might discuss other options.
You can download the application, and your doctor needs to also sign. It's pretty simple and quite quick.
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1 ReactionThanks you for this The only hitch is my doctor. We have no relationship at all! I have never met her, only spoke to her once via cell at our first "meeting." Any communication has been done by her assistants & when I sent her a message that I would really appreciate having an actual meeting, I got a phone call message from someone who really reamed me out. I have given up on her.
I wanted to get Forteo or Tymlos but the financial aid application timeline ruled that out. I have gone far too long with pretty bad numbers to risk another extension. So I am stuck with Prolia for now. But not with her. I am going to see if I can switch to another branch of UW Endocrinology which is closer to me re driving time - which really makes sense especially during Wisconsin winters.
You have been a great help!
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1 ReactionThe Radius Assist application is quick. It really is better to do Tymlos first, but I understand your dilemma. Any doctor or nurse practitioner can sign the forms. Maybe you could at least print them out. The forms require very little from a doctor. Whoever prescribed Prolia can easily just sign the application. I actually drove it to the clinic as I remember.
Just get any provider to sign the paper. You fill out most of the form and include financial documentation (tax form), It really is easy.
The other link for Tymlos https://tymlos.com/access-and-savings/
Howdy, @windyshores!
Can you give me additional information about the Radius Assist program? I thought those of us on Medicare and/or other commercial insurance were automatically excluded. Additionally, I was unable to find info about any exceptions or possible discussion for funding with income above 300% of the federal poverty level (which, I seem to remember is about $54k for two people in a household).
Thanks, Windy! Cheers!
I believe there are coupons/discounts for those under 65 on commercial insurance but I don't know much about that.
I was over 65 and on a Medicare Advantage Plan when I received Radius Assist help It is absolutely available for people on Medicare.
The Tymlos site has info on savings "cards" for those on private or commercial insurance
https://tymlos.com/access-and-savings/ These are for under 65 I believe.
For funding for those with incomes above the 300% of the federal poverty levels, on Medicare, I would make a call. Back when I started Tymlos in 2021 there was a program called Together with Tymlos, in which I had a personal representative who guided me. I cannot find that now.
So I would call Radius to discuss. 866-896-5674 And of course call your insurance! Good luck! Sorry not to be more helpful!
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2 ReactionsYou’ve been very helpful, @windyshores! I appreciate your reply! It all might be water over the dam anyway as I discontinued Tymlos over a year ago - but perhaps worth a try for reimbursement.
Cheers!
@beanie one for those of us on Medicare, it is free Tymlos but actual money isn't involved. But let us know if you succeed!
I've posted this on some of the similar threads. I got 100% funding for Forteo. I go to a major clinic, begins with O. Their staff encouraged me to apply (hounded me actually). I filled out the paperwork and sent it back to their staff at the clinic. I was approved. My income is enough higher than the poverty level that I did not think I would be approved. Surprised when I found out I was. I was on it from fall of 2021 ending fall of 2023.
Fosamax beginning in fall of 2023 for those wondering.
My application for aid is still being processed at UW with a ways to go but what they come up with might be interesting given your experience!
@guinivere is there a reason you don't want to print out the Radius Assist application, sign it, and give it to (any) doctor to sign? You just attach a tax return. It takes two weeks to go through.
It is so hard that you have been waiting for UW.