@carlsbadguy
I’m really puzzled by this. If the drug is in your formulary You’re being on it more months than they allow is not taking it out of the formulary. If your doctor requires you to be on 18 months, then those other six months should be covered by the Medicare limit.

Whoever your supplemental is for drugs, can’t tell you that the Medicare limit doesn’t apply because they think you can’t take more than 12 months. Many prostate cancer patients needed 18 months to two years. In my case, I’ve been on ADT for nine years, The Medicare limit counts because my doctor requires I be on it. It’s no longer that it’s not in their formulary. It’s not in their guidelines, which are almost definitely subject to a second opinion for those that have more advanced cases of prostate cancer.. You are not alone in this. There are a huge number of people that have to be on ADT for 18 to 24 months. You need to appeal this.