Forteo (teriparatide) is a brand-name medication that doctors may prescribe to treat osteoporosis. The drug uses proteins to enhance bone strength and promote the development of new bone tissue. You must receive 1 injection of Forteo under your skin per day.
Medicare may cover Forteo injections. But receiving Medicare drug coverage depends on the specific plan or part and on how you administer the drug.
Original Medicare (parts A and B) only pays for medications you can’t administer yourself. So, Original Medicare may cover injectable medications for osteoporosis, such as Forteo, if you:
- are a female assigned at birth (FAAB) who has osteoporosis
- qualify for Medicare’s home health services
- confirm with your doctor that your bone fracture relates to postmenopausal osteoporosis
- determine with your doctor that you need assistance with injections and that family members or caregivers can’t help with this
You should receive equivalent coverage if you have Medicare Advantage (Part C) insurance.
If you can administer Forteo yourself, you may get Forteo coverage under Medicare Part D or a Medicare Advantage prescription drug (MAPD) plan.
Private insurers manage these plans. Whether your plan covers this drug depends on your chosen plan and its formulary, which is a list of its covered drugs.
With both types of drug coverage, your plan must cover at least two drugs from commonly prescribed drug categories. This means that many Medicare drug plans may cover Forteo. If they don’t, they often cover alternative drugs within the same category with similar effectiveness.
Is there a generic substitute for Forteo?
The generic version of Forteo, teriparatide, is also available as a subcutaneous injection.
Generic medications contain identical active ingredients to their brand-name counterparts, providing the same safety profile and effectiveness.
If you have coverage from Medicare Part D or an MAPD plan, your plan may cover the generic version, which may cost less out of pocket than the brand Forteo.