Can Someone Tell Me If Medicare Pays For Forteo?

Question

Asked by DN

Can Someone Tell Me If Medicare Pays For Forteo?

I've read some on line answers to this question and I've become even more confused.

Can you tell me which Medicare Part D plan is the best one to sign up with while I'm using this drug?

Thanks.

Answer

Hi DN, welcome and thanks for your question. If you are currently trying to decide which Part D plan to choose, you can access most of them online and see if they cover Forteo. Another option would be to make a list of all the plans you are considering and call each one and ask if Forteo is covered and what the copay price is. I know some of them cover it, but it has a relatively high copay price. You might be able to find one that has a lower copay, but the only way to do that is to call each one or look at each companies formulary (covered drugs) online. Most of the insurances that cover it have it listed as a tier 4 or "specialty med" which "usually" means it cost 20% of the retail price. I'm not sure what retail is right now but it's around 1,000.00 a month. So 20% of that isn't cheap. See if you can't find a plan that has it listed at a lower copay price.

Good luck trying to find one.

Answered by Pam Flores