Forteo® Medicare Coverage

Forteo is used to treat osteoporosis by building healthy bone growth and slowing bone loss for men and post-menopausal women at a high risk of developing fractures.

It is a once daily subcutaneous injection given in the abdomen or thigh with or without food or drink. This injection is stored in the refrigerator at 36-46 °F and must be used directly after being removed from the refrigerator.

Common side effects with this medication include high calcium levels, dizziness, leg cramps, muscle pain and nausea. A serious side effect that can occur is increased risk of bone cancer called osteosarcoma.

Forteo has been proven to increase bone mineral density and reduce the risk of fractures in post-menopausal women, but is also approved for use in men.

How much does Forteo cost with Medicare?

Forteo coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.

Contact your plan carrier or consult your plan formulary for more cost information.

Does Medicare cover Forteo?

According to GoodRx, 73% of Medicare Advantage plans and Medicare Part D plans covered Forteo in 2023.¹

• Medicare Advantage plans or Part D plans that cover Forteo include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug coverage kicks in.
  
  
• Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). 89% of 2023 Medicare Advantage plans included prescription drug coverage.²
  
  
• 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 Forteo. We represent carriers such as Humana, UnitedHealthcare^®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

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.

Additional information

Osteoporosis is a disease where the density and quality of the bones are reduced, which increases the risk of fractures and other complications such as infection and even death.

Forteo promotes growth of new bone to treat osteoporosis, unlike other therapies that may only improve the bone density of current bone. This medication is supplied in a delivery device and must be discarded 28 days after use even if there is medication remaining.

Forteo should not be taken for more than 2 years and should not be used in patients at an increased risk of osteosarcoma.

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.