Medicare Advantage Drug Cost for Tymlos



There are 64 Medicare Advantage Plans with additional prescription drug coverage for Tymlos available to residents in Texas. The average retail unit cost (e.g. per pill) for a 30-day supply at in-area retail pharmacies is $1,556.60 ($46,697.91). Tymlos is typically listed as a Tier 5 drug on the formulary and does not require prior authorization.

Below is the average retail cost and your co-pay for Tymlos in Texas. You can also see if each plan requires prior authorization, step therapy or has drug quantity limits. Please check the formulary for different brand and generic drug names. Every Medicare Advantage Plan will vary in coverage, co-pays, costs and premiums. This chart can help you sort through different plan details to find a Medicare Advantage Plan in Bexar with the best coverage and the cheapest prices for your medications in Texas.



Proprietary Name:Tymlos
Generic Name:Abaloparatide
Drug Package:1 Cartridge In 1 Box, Unit-dose
Drug Strength:2000ug/mL
Substance:Abaloparatide
Dosage Form:Injection, Solution
Route:Subcutaneous
Labeler:Radius Health, Inc.
Pen Name:Human Prescription Drug
NDC#70539000102
RX#1921081
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Bexar





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Medicare Advantage Coverage for Tymlos in Texas


Click the Plan Name for More Details
Click the header to sort
Plan
Name ⇅
Tier
Level
Your
Cost
Preferred
Cost
Non
Preferred
Cost
Mail
Limit
Amt/
Days
Prior
Auth
Y/N
Step
Therapy
Y/N
Avg
Unit
Cost
(x30)
AARP Medicare Advantage

5NA33%33%/YN$1,565.62
($46,968.55)
AARP Medicare Advantage Choice

5NA29%29%/YN$1,565.62
($46,968.55)
AARP Medicare Advantage SecureHorizons

5NA33%33%/YN$1,565.62
($46,968.55)
Amerivantage Choice

533%33%NA/YN$1,589.63
($47,689.03)
Amerivantage Classic

533%33%NA/YN$1,592.38
($47,771.47)
Amerivantage Classic Plus

533%33%NA/YN$1,592.43
($47,772.76)
Amerivantage Select Plus

533%33%NA/YN$1,589.63
($47,689.03)
Blue Cross Medicare Advantage Choice Plus

527%27%27%/YN$1,458.74
($43,762.15)
Blue Cross Medicare Advantage Classic

529%29%29%/YN$1,458.71
($43,761.30)
Blue Cross Medicare Advantage Flex

525%25%25%/YN$1,463.38
($43,901.54)
Blue Cross Medicare Advantage Value

533%33%33%/YN$1,457.77
($43,733.20)
Cigna Preferred Medicare

533%33%33%/YN$1,569.59
($47,087.84)
Cigna Preferred Savings Medicare

533%33%33%/YN$1,563.97
($46,919.17)
Cigna True Choice Medicare

533%33%33%/YN$1,556.56
($46,696.71)
Cigna True Choice Plus Medicare

533%33%33%/YN$1,556.56
($46,696.71)
Community First Medicare Advantage Alamo Plan

5NA29%NA/NN$1,529.46
($45,883.79)
Humana Gold Choice H8145-084

5NA29%29%/YN$1,586.15
($47,584.40)
Humana Gold Plus H0028-030

5NA33%33%/YN$1,608.63
($48,258.76)
HumanaChoice H5216-042

5NA29%29%/YN$1,588.48
($47,654.38)
HumanaChoice H5216-043

5NA33%33%/YN$1,571.12
($47,133.47)
HumanaChoice R4182-003

5NA30%30%/YN$1,584.70
($47,540.90)
HumanaChoice R4182-004

5NA30%30%/YN$1,584.70
($47,540.90)
Imperial Insurance Company Traditional

5NA33%NA/YN$1,485.56
($44,566.94)
Imperial Insurance Traditional Plus

5NA25%NA/YN$1,485.56
($44,566.94)
UnitedHealthcare Medicare Advantage Choice

5NA26%26%/YN$1,563.22
($46,896.50)
Wellcare Assist

525%25%25%/YN$1,551.84
($46,555.27)
Wellcare Complement Assist

525%25%25%/YN$1,551.73
($46,551.93)
Wellcare No Premium

533%33%33%/YN$1,552.84
($46,585.32)
Wellcare No Premium Rx Plus Open

528%28%28%/YN$1,563.84
($46,915.07)


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SNP Prescription Drug Cost for Tymlos

Click the Plan Name for More Details about that Plan
Click the header to sort
Plan
Name ⇅
Tier
Level
Cost
Preferred
Cost
Non
Preferred
Cost
Amt
Mail
Limit
Days/
Amt
Prior
Auth
Y/N
Step
Therapy
Y/N
Avg
Unit
Cost
(x30)
American Health Advantage of Texas

1NA25%NA/YN$1,482.50
($44,475.04)
Amerivantage Comfort Plus

5NA33%NA/YN$1,409.37
($42,280.97)
Amerivantage Diabetes Care Plus

533%33%NA/YN$1,592.33
($47,769.83)
Amerivantage Dual Coordination

525%25%NA/YN$1,592.38
($47,771.47)
Amerivantage Dual Coordination Plus

525%25%NA/YN$1,593.55
($47,806.45)
Amerivantage Dual Secure Plus

525%25%NA/YN$1,587.81
($47,634.16)
Amerivantage ESRD Care

531%31%NA/YN$1,591.46
($47,743.73)
Amerivantage Heart Care Plus

533%33%NA/YN$1,592.33
($47,769.83)
Amerivantage Lung Care Plus

533%33%NA/YN$1,592.33
($47,769.83)
Blue Cross Medicare Advantage Dual Care Plus

1NA$0NA/YN$1,476.18
($44,285.48)
Cigna TotalCare

5NA15%NA/YN$1,603.11
($48,093.32)
Community First Medicare Advantage D-SNP

5NA25%NA/NN$1,529.43
($45,882.82)
Humana Gold Plus - Diabetes and Heart

5NA33%33%/YN$1,608.41
($48,252.17)
Humana Gold Plus SNP-DE H0028-036

5NA25%25%/YN$1,608.31
($48,249.31)
Imperial Insurance Company Dual

5NA25%NA/YN$1,483.31
($44,499.17)
Imperial Insurance Value

5NA33%NA/YN$1,485.56
($44,566.94)
ProCare Advantage

1NA25%NA/NN$1,613.23
($48,396.95)
Provider Partners Texas Advantage Plan

1NA25%NA/YN$1,487.53
($44,625.97)
Provider Partners Texas Community Plan

1NA25%NA/YN$1,487.53
($44,625.97)
Texas Independence Health Plan, Inc.

1NA25%NA/YN$1,486.37
($44,591.05)
UnitedHealthcare Assisted Living Plan

5NA33%33%/YN$1,561.01
($46,830.16)
UnitedHealthcare Chronic Complete

5NA33%33%/YN$1,565.62
($46,968.55)
UnitedHealthcare Dual Complete

5NA15%NA/YN$1,565.62
($46,968.55)
UnitedHealthcare Dual Complete Choice

5NA$0NA/YN$1,563.22
($46,896.50)
UnitedHealthcare Medicare Gold

5NA28%28%/YN$1,563.22
($46,896.50)
UnitedHealthcare Medicare Silver

5NA25%NA/YN$1,563.22
($46,896.50)
UnitedHealthcare Nursing Home Plan

5NA25%NA/YN$1,562.94
($46,888.34)
Wellcare Dual Access

1NA$0NA/YN$1,551.87
($46,556.04)
Wellcare Dual Access Harmony

1NA$0NA/YN$1,551.65
($46,549.51)
Wellcare Dual Access Open

1NA$0NA/YN$1,551.80
($46,553.90)
Wellcare Dual Liberty

1NA$0NA/YN$1,551.87
($46,556.04)
Wellcare Dual Liberty Nurture

1NA$0NA/YN$1,551.67
($46,550.00)
Wellcare Specialty No Premium

533%33%33%/YN$1,559.52
($46,785.56)


Do any Medicare Advantage Plans Cover Tymlos? Yes, 64 Medicare Advantage Plans cover this drug in Texas.

How much does Tymlos Cost? $1,556.60, the average retail cost in Texas is $1,556.60 per unit or $46,697.91 for a 30-day supply at in-area pharmacies.

What Tier is Tymlos? Tier 5, most Advantage Plans list Tymlos on Tier 5 on their formulary. Usually, the higher the tier, the more you have to pay for the medication.

Do I need Prior Authorization for Tymlos? Yes, the majority of Medicare Prescription Plans do require prior authorization from your doctor for Tymlos.



Additional Notes by Medicare Help:

Most plans have 4 levels of coverage. The exception is the $0 Deductible Plans.
1.Pre-Deductable: Before you reach the plans deductible. Some plans offer select Pre-deductible drug Coverage
2.Initial Coverage: (ICL) After you reach the plans deductible but before the Initial Coverage limit.
3.Coverage Gap: (AKA Donut Hole) After you reach the plans ICL but before the Catastrophic of $7550 in 2022.
4.Catastrophic: Anything over $7550 you will receive a significant increase in coverage.

Formulary Definitions:

Tier Level: Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost. A drug in a lower tier will generally cost you less.
Cost Preferred: Your Cost for the Drug at the Providers In Network Preferred Pharmacy. As a Percent of the total drug cost or a flat rate.
Cost Non Preferred: Your Cost for the Prescription Drug at a Non-Preferred Pharmacy. As a Percent of the total drug cost or a flat rate.
Cost Mail: Your Cost for Prescription Drugs through a Mail Order Pharmacy. As a Percent of the total drug cost or a flat rate.
Quantity Limit Amount/Days: Certain drugs have a Quantity Limit. That means the plan will only cover the drug up to a designated quantity or amount. If your prescribing doctor feels it is necessary to exceed the set limit, he or she must get prior approval before the higher quantity will be covered.
Prior Authorization: Certain Drugs require you or your doctor to get prior authorization in order to be covered. Usually just an additional form. If you dont get approval, the plan may not cover the drug.
Step Therapy: Means you must first try one drug to treat your medical condition before the plan will cover another drug for the same condition. If you have already tried other drugs or your doctor thinks they are not right for you, you and your doctor can ask the plan to cover this drug.
Avg Unit Cost: Average unit cost (e.g. per pill) for specified days supply at in-area retail pharmacies. A pharmacy is considered in-area when it is geographically located in the service area.




What if a drug I need is not listed?

Please check the formulary for different brand and generic names. If you still cannot locate your drugs, your plan may not offer coverage. Talk to your doctor first about changing your prescription to a drug on your plans formulary. If this is not an option, you can request an exception to have the plan review its coverage decision based on your individual circumstances.

Last updated on
Source:CMS Formulary Data Q4 2022
Source:NDC Directory by FDA.gov

**We make every attempt to keep our information accurate. But please check with the plan providers to verify all information.

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*Licensed Agent Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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