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Cost Of Prolia
A MyOsteoTeam Member asked a question 💭

I’ll be getting my next Prolia shot soon. The first two were covere d by Medicare. Does anyone know whether subsequent Prolia shots are covered fully? My pharmacy wanted $900. The drug cost about $1500.
Evie

posted August 16, 2022
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A MyOsteoTeam Member

Wow! That's expensive! I'm avoiding taking any drugs for the time being, will see if I can hold to that, with my exercise and eating regime. That will really suck if Medicare only covers 2 shots, doesn't make any sense.

posted August 17, 2022
A MyOsteoTeam Member

I get the shot every six months. Have to have a blood test for Caliumlevel first.
Medicare has paid so far.

posted September 4, 2022 (edited)
A MyOsteoTeam Member

I took only one Prolia shot. It made every muscle/bone in my body hurt for most of the six months until I didn't take the second shot for the year timeframe. Prolia is covered by Medicare because it is an injection. I understand most injections are covered by Medicare if it is an accepted medicine. You could check with your Medicare insurance carrier to be sure. my shot was $65.00. I can't take it, it about killed me and then finally started to wear off...I think. I still have pain in my back but had that before I took it. I do not know if the Advantage plans cover it or not. Advantage plas are supposed to cover everything that Medicare covers. You need to know if you have regular Medicare with the US Government or an insurance company which calls their plan Advantage Plans. I mention that, because some people do not know. As I understand it, when Medicare law was passed, the insurance companies thought they could do better and so the government allowed insurance companies to set up plans for senior citizens. Their plans are a contract with the US government to pay them certain amounts to cover those they insured. I have not kept up with the prices but it used to be something like $9500 for someone with not too many issues but the government would pay the insurance companies somehting like $12,500 for each insured that had many issues. These $$$ amounts have changed I am sure. People need to check closed what Advantage plans offer. Those that offer no premium sometimes have a co-pay of 20%. That is what many people who get very low Social Security payments sign up for. At least there is some coverage....with the thought that they are trying to pay their way. At least it is something. You can check with your insurance agent on all those amounts.

posted October 20, 2022
A MyOsteoTeam Member

I have been on the shot for the past ten years. According to my bone density tests it has improved the condition.
Still have pain but not as bad. I also take extra strength Bio Flex

posted September 25, 2022
A MyOsteoTeam Member

Thanks Barbara, how many years have you been on it and has it helped?

posted September 4, 2022

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