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← Return to Lupron or Not at 76?
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Prostate Cancer | Last Active: 5 hours ago | Replies (148)
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I have the same plan. I'll check the website but the formulary from last October (for 2026) shows:
ORGOVYX ORAL TABLET 120 MG: PA-NS; LA; QL
PA-NS stands for Prior Authorization for New Starts: This means that if this drug is
new to you, you will need to get approval from us before you fill your prescription.
If you are taking this drug at the time of enrollment, you will not be required to
meet criteria for approval.
Hopefully approval is not a pain.
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@tbgb50
My oncologist got a "Coverage Determination" which was expedited and approved. I'm not sure what LA stands for but I'm pretty certain QL stands for Quantity Limits, which if I understand it correctly means "Coverage 1 year". I'll talk to my oncologist to see if there was a limit on the number of months when he got the coverage determination. I'll also talk to Wellcare, and if they only cover the drug for 12 months total, I'll switch plans for 2027.