"Six Month" Lupron, date for next injection? When does insurance cover it?

So I'm on 2 years of ADT with Lupron, and likely Casodex the whole time too. My first Lupron was a 6 month shot.

The documentation for Lupron 6 month depot shows the next injection date at 24 weeks, arguably 6 months. The problem I'm seeing is that 24 weeks is not considered 6 calendar months. So, what will the insurance company do? I have BCBS.

My uro's office warned me that insurance won't pay unless it is fully 6 months, plus a day or two for safety. My first injection was May 1. Thus a full 6 calendar months would end Oct 31. They scheduled my next injection for Nov 6, the following Wednesday. That's well over 24 weeks, actually 27.

I'm a bit concerned about testosterone rising during those last 3 or 4 weeks. We've wrestled my PSA below 0.1, and I don't want to give it any reprieve.

Does anyone have insight on the insurance company's coverage for this? I can't find anything conclusive on line. Or, a suggestion for the next step? Better to call the insurance company directly, or maybe have my uro's office contact them for preapproval?

Thanks in advance for any insights...

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IGRT by IMRT, 44 done 8/28/13: 50.4 Gy pelvic nodes, 79.2 Gy prostate
ADT2 2 yrs: Lupron 5/1/13+Casodex 6/25/13

Age 55 @ Dx 4/16/13-
Bx 6/12 pos all on rt G9=5+4 (80%, 60%), 4+5 (2 at 100%, 80%, 10%), PNI confirmed
3T MRI: Bilateral EPE, NVB+, SV-, LN-, cT3

Date PSA fPSA
8/13 <0.1 (ADT, post-RT)
6/13 9.7
3/13 5.2 12% PCA3=31
9/12 4.1 15%
history since 2002 high/varying PSA, 3 neg bx

I would definitely call the insurance company. Lupron is an expensive injection. We had problems with the insurance not wanting to pay for my husband's Lupron & it was quite the ordeal getting it straightened out but it's all good now. When we went to get a second opinion the Dr suggested getting a 3 month injection next time, given in the stomach and the cost would be around $300, Charlie's first injection was a 6 month injection, given in the hip and the cost was $2800. Not sure why there is such a difference in cost or if one way is better than another. Anybody know the answer? I will contact the insurance company before going to the 3 month injection.

FYI, I get one month Lupron shots, which are always scheduled at least 4 weeks apart. I've always been told that I could never go one day less than that or insurance would not pay. But the 4 weeks means that my 1-month shots are obviously slightly less than a month apart. I'm having my next one this Tuesday, which is 29 days since the one before, but I'm generally right on the 28-day cycle.

I'm not sure if the math would be any better for you if you were to take one month shots, nor do I know if it's even desirable for you to drag your butt into the office (pun intended) every month for your shot.

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Age 52, Diagnosed at 51
PSA 9.6, Gleason: 9 (5+4), three 7s (3+4)
Chose triple play of HDR brachy, IMRT and HT (Casodex, Lupron and Zytiga)
PSA 1/13=0.249 (After HT, but pre-brachy/IMRT)
PSA 4/13=0.09 (post brachy/IMRT)
PSA 7/13=0.01
PSA 9/13=0.01
Testosterone: Below 20 since starting HT

SC,

Interesting on the formulation. Regardless, my insurance pays at 6 calendar months. Clearly the days/weeks vary based on the length of the month, but they count months, not days. I suspect it is just easier for them. I have no real leverage, so I learn to deal with the system provided.

If that's the way it's calculated, isn't there possibly a tiny benefit to taking the monthly, I mean 4-week shots? That way there's only 2-3 days missing per month, rather than a larger missing period between 24 weeks and the six months that insurance would pay?

Of course, I'm not sure if there's any appreciable difference in that approach.

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Age 52, Diagnosed at 51
PSA 9.6, Gleason: 9 (5+4), three 7s (3+4)
Chose triple play of HDR brachy, IMRT and HT (Casodex, Lupron and Zytiga)
PSA 1/13=0.249 (After HT, but pre-brachy/IMRT)
PSA 4/13=0.09 (post brachy/IMRT)
PSA 7/13=0.01
PSA 9/13=0.01
Testosterone: Below 20 since starting HT