Tymlos injectible pen

tangydog is correct, anyone on Medicare will only pay 2000.00 for the year 2025 for all their medication. There is one catch, if a medication you are on is not in your insurers prescription drug formulary and they do not approve it I am told by my insurer, WellCare Value Script that it does not fall under the annual 2000.00-dollar cap, so you may end paying for other medications you are on above the 2000.00 cap. Also, it is my understanding the Medicare 2000.00 cap may adjust annually meaning it may go up or down for 2026.

yes, I used Wellcare last year, but dropped them when I discovered they dropped support for Tymlos for 2025.

Terriparitide and Tymlos are not on WellCare formulary. We simply had are dictor request an over ride of their formulary and they did for both. Started Teriparitide for 3 months, Doctor switching me over to Tymlos in one week. Apparrantly Tymlos is more directed towards osteoporosis where Teriparitide is more general a medication.

teriparatide is Forteo, and abaloparatide is Tymlos. Both are specifically for osteoporosis. There is some evidence that Tymlos is a little more effective. Maybe that is why the doctor is switching you over?

Thankyou for clarifying medsjl2025. Yes when I selected my D coverage I looked for ones with Tymlos on the formulary. I have Cigna. Let's hope the cap doesn't go up too much in 2026. My Dr changed his mind and wanted to put me on Evenity but too late I already had Cigna and Evenity is not on their formulary. I've been on about 2 weeks now. Will say, my only issue is that I am getting up many times per night to use the restroom. I need to take at night due to other meds.

tangydog, lucky strike getting on Forteo or Tymlos instead of Evenity. Your stars must be aligned.

I started Tymlos 01/25 and pay a $30 monthly copay. I have Medicare (started 10/24)and a Part B and D. I am on no other prescription and never paid $2000. Maybe my secondary plan and Part D made my insurance situation different?

I’m on Medicare part B and D but my prescription costs more. $O first month, $78 2nd and then $138 rest of months. Must be different on what part D plan you choose. I am on WellCare drug plan which is 50 cents a month and receive Tymlos from Walgreen specialty pharmacy. I began on Tymlos this month. I’m understanding that through my doctor and having fractures enabled WellCare to accept Tymlos. I am wondering if they will carry through for next year.

Munday, bet we all wish we had your plan. Medicare plans do vary by state as do secondary health plans, the largest secondary health plan out there is United Health AARP, as far as I know they do not get involved with any actual medication coverage. As for Medicare prescription plans, you get what you pay for. Currently WellCare Value Script is $0 per month premium but then their formulary is smaller, some Medicare prescription plans cost in the $100's of dollars a month, but then again, they may cover a wider range of medications. as they say, pay now or pay later, I guess.

Mundy which D plan are you on. Thanks