Tymlos insurance approval

Posted by alexandercrps @alexandercrps, 6 days ago

51 year old male with Complex Regional Pain Syndrome type 2 and a year old Osteoporosis diagnosis. My doctor prescribed Tymlos but for over 8 months now my rx has been denied by my insurance company twice. I hate this stupid health care system where an insurance company has more power that a physician specialist; because of them I have lost several months
of valuable bone building time. Has anyone else had issues getting Tymlos approved by your insurance ? It has almost been a year since this medicine was first prescribed. And my doctor even called me last week to see if I could provide him with a working fax number to send the appeal letter to; he said insurance companies hide these fax numbers as way to delay and defer..it just sucks to pay so much for an insurance plan every month when you don’t even get the meds you need. My second question reg Tymlos is, is it worth the wait if I finally do get it approved? My doc wanted me to be on Tymlos for a year or two to improve my t-score. Hopefully I get this rx
approved soon so can begin to build back bone again..

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

@alexandercrps
Welcome to Mayo Connect. I have been in your situation where an insurance company limits my prescription options. But it was not for Thymols. I am glad your provider is working with you to get approved.

Have you checked out the drug company's web page for financial assistance?
https://www.tymlos.com/access-and-savings/ .
Unfortunately, the type of insurance limits their help, and it is available only for prescriptions covered by commercial or private health insurance.

About your other question, is it worth pursuing? There is a new discussion about Tymlos Success you might want to read:
https://connect.mayoclinic.org/discussion/tymlos-success/

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