Tymlos (Abaloparatide) Medicare Coverage

Tymlos
Chemical name: Abaloparatide

Brand name: Tymlos

Typical dosage: 1.56ml of 80mcg

Typical type: Injection1

Tymlos is a medication used to treat osteoporosis. Tymlos is available as a brand-name drug and comes as a subcutaneous pen-injector.

Tymlos is a medication that contains the active ingredient Abaloparatide. It is used to treat osteoporosis in post-menopausal women who are at high risk for bone fractures or who have failed other available osteoporosis therapy.

Tymlos stimulates cells called osteoblasts that help re-build your bones and prevent them from degrading further. It is typically injected once daily.

Common side effects of Tymlos include dizziness, upset stomach, headache, fatigue and irritation where you give the injection.

Does Medicare cover Tymlos or Abaloparatide?

Some Medicare Advantage plans and Medicare Part D plans may cover Tymlos.

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.1

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Tymlos.

Find Medicare Advantage plans with drug coverage

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

 

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Average costs for Tymlos with Medicare drug coverage

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in and the Medicare drug plan you have.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.

Additional information

Tymlos is given as an injection. It should be given into the fatty part of the skin in the stomach area. Move the site where you give the shot every day.

Do not give the shot into skin within 2 inches around the belly button. Do not reuse needles, and dispose of used needles in a safe place, such as a sharps container.

Use for over 2 years is not recommended. Avoid taking this medication if you have a history of Paget’s disease. Let your doctor know if you feel bone pain, pain that does not go away, unusual lumps or swelling under the skin that is tender.

Let your doctor know if you experience signs of high calcium levels such as weakness, confusion, fatigue, headache, upset stomach, constipation or bone pain.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.