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darlene194 posted:
I was diagnosted apt. 4 years ago.
my Dr. put me on prolia,took for 1 year.
Now my insurance refuses to pay for it.
Is it because my family Dr. prescribed it and not a bone Dr. or what?
bonebabe responded:
No, it doesn't matter which doctor writes the RX. You need to contact your insurance company and ask. It could be a simple coding error on the part of the doctor.
darlene194 replied to bonebabe's response:
Ok now the dr. says its not osteoporsis.
He gave me a bone density test and says it is osteopenia,which is suppose to be the start of the other.He has not put me on any kind of meds.for it.I also read up on it and found that it also can affect you if you have harden of arteries,which I do
Should I get the openion from a bone doctor or what?
bonebabe replied to darlene194's response:
Osteopenia means low bone density. Whether or not you need a med depends on other factors that you need to know. They are:
What was your lowest T-score?
Have you broken a bone after age 40?
Are you on prednisone?
Can you stand unassisted on one foot > 5seconds?
If you had a FRAX assessment, what was the result?

You most likely should not be on Prolia. It's a medication to be taken only after all other osteo meds have been tried.

Osteoporosis is defined as having a T-score lower than -2.5 or having had a vertebral or hip fracture.

Having osteopenia in itself does not mean you won't fracture, especially if you have other risk factors for fracture.

If you have osteopenia and have the presence of at least one of the above risk factors, you should be on a medication. Those are the clinical standards. Some of the meds, like Fosamax, have been approved for the prevention as well treatment of osteoporosis.

Look at the NOF website ( ) under the medication section to get some more information, then talk to your doctor.
darlene194 replied to bonebabe's response:
Thank you I will check it out
stellagonzalez responded:
Doctors may vary it's just about the insurance company how they look at your insurance whether your disease included or not.

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