I am having the exact same issue with my wife. Except I will tell you the medicine. Relpax. Its a migraine RX and its very expensive.
It was on the formulary last year and the years before that. It is just now, this year, they removed it from the formulary. We did not check before re-signing with our current Medicare provider. My bad!
Since its not on the formulary and she has Medicare Advantage, she has two(2) options.
1) Pay full price.
2) Appeal and have the doctor send a letter regarding the RX and why she must have it. Get an exemption.
We are waiting on the insurance companies response.
If you are on Medicare and have RX benefits, you have a private insurance company providing your Medicare health care needs. Part "D" prescription benefits.
Medicare alone, for the record does not cover RX. But, Medicare Advantage plans do.
So, get your doctor to write the letter.
I do not know if that will even work, but its at least an attempt.
Next November, look at the formulary BEFORE you sign on with any Medicare provider. Make sure all your meds are on the formulary.
Go to Medicare.gov: the official U.S. government site for Medicare
and look for "Find Health and Drug Plans".
Personalize your search so you can save your entries. This is where you will find out if your drug is covered or not.
You can also look for "extra help" in this same section. Just because Medicaid is not available in you're state, does not mean you cannot receive extra help.
Unfortunately, most folks make to much money to qualify for extra help.
But try and see. You never will know unless you try.
Do this every Nov, to be certain you have the best policy available for your zip code.
Never remain loyal to any Medicare provider. (actually any ins company) Check everything available every single year in Nov. Make sure you make an informed decision every year.
If you qualify for extra help, there is no reason to shop your plan each year as the extra help pays for what Medicare plans do not.
Good luck and keep us posted.