Discussions that mention evista

Back Problems board


Hi Carol and Tucsonlady: Have either of you tried to appeal your insurances decision on fosamax? I've never heard of an insurance that doesn't cover "some" osteo med. I know with my MediCare Part D they pay for it, but there are other things they don't. In my case where I needed to take something and it wasn't covered I did an appeal, where your Dr fills out the paperwork and faxs it to them stating that the drug is medically necessary. I was able to get them to cover things that they didn't cover in the past.

Just an idea; I know a lot of instances where people were sucessful with this process. Fosamax is going off patent next year so maybe they will cover the generic. But if you have osteoporosis, you should take something, whether its a serm (evista), bisphosphonate (fosamax, actonel etc), or pth, plus calcium/D/magnesium and exercise if you can. Will your Drs give you samples??? I'm on a osteo med where my copay is 60.00 a mo (injectable parathyroid hormone) and now that I'm in the coverage gap/donut hole the retail price is 676.00 a mo, so I'm getting the med from my Dr since she say's I "have" to take it, and I certainly can't pay 676.00 a mo, so if she wasn't giving it to me I'd be up a creek so to speak:( These meds expire too, so if they don't give away the samples they have to toss them.

Good luck...