Does Medicare Cover Reclast?

In this article...
  • Bone loss is a common condition in older adults that's often caused by osteoporosis or Paget's disease. Reclast may help slow down bone loss. Learn more.

Osteoporosis and Paget's disease are bone conditions in which the body's bone regeneration process is slowed down or interfered with, leading to bone weakness and the potential for easier bone breaks and fractures. Reclast and other medications designed to increase bone density and slow down the bone loss process are often recommended for individuals with osteoporosis or Paget's disease to help strengthen bones and possibly prevent fractures. 

Is Reclast Covered by Medicare? 

Reclast is generally not covered by Medicare Advantage plans or Medicare Part D prescription plans, but the plans may cover other medications and medical treatments for osteoporosis and Paget's disease. Medicare recipients should expect to pay full out-of-pocket costs for Reclast, which range from $1,083 to $1,119.26. While Medicare typically doesn't offer coverage for Reclast, other insurance plans may cover up to 98% of its costs, with copayments ranging from $60 to $82.50 per prescription.

How Does Reclast Work?

Reclast is prescribed in both injection and pill form for individuals with osteoporosis and those at risk for developing the condition. Injectable infusions are generally given as a single dose or recommended every 1 to 2 years, and they take approximately 15 minutes to complete. Reclast is in a class of medications called bisphosphonates that support increased bone mass and help slow down bone loss, which may also aid in preventing or slowing down the progression of osteoporosis by strengthening the bones.

Does Reclast Cause Any Side Effects?

Some common side effects of Reclast include bone pain, joint pain and muscle aches. Individuals may also experience flu-like symptoms following their first injection of Reclast, but these symptoms usually subside within a few days. Reclast may cause gastrointestinal side effects such as diarrhea, heartburn and stomach upset.

What Causes Osteoporosis?

Osteoporosis occurs when the body's process of regenerating and renewing bone mass begins to slow down, which can lead to weakened bones and bone loss. In most people, bone mass loss is a natural part of life, and many risk factors such as age, sex and body frame size are out of their control. However, there are also certain external factors that may contribute to the development of osteoporosis.

Individuals with diets low in calcium and those with calcium deficiencies are considered at higher risk for osteoporosis, as low calcium levels in the body may contribute to early bone loss. Past gastrointestinal surgery is another risk factor due to the fact that removal of a portion of the intestine may hinder its ability to absorb calcium. Long-term use of medications for seizures, acid reflux and transplant rejection are also associated with the development of osteoporosis.

Are Paget's Disease and Osteoporosis the Same? 

Paget's disease and osteoporosis are often managed and treated with the same medications and treatments, and people can be diagnosed with both conditions at the same time. However, the two conditions are separate from one another. Similar to osteoporosis, Paget's disease interferes with the regeneration and remodeling process of the bones, but it is believed to be caused by an immune response and often leads to bone enlargement. Osteoporosis often develops due to natural age-related factors, but it can be worsened by medications, diet, hormonal fluctuations and menopause. Both conditions can cause bone weakness and increase the risk of bone fractures.

What Are Some Symptoms of Osteoporosis? 

In its early stages, individuals with osteoporosis may not experience any symptoms. As the condition develops over time, some common symptoms include back pain, loss of height and a slightly stooped posture. Osteoporosis can also lead to easier bone breaks and fractures because it causes the bones to weaken over time. 

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