Not all doctors and insurance plans accept Subutex prescriptions. However, it is possible to obtain these prescriptions for people struggling with opioid addiction through various programs, including Medicaid and Medicare.
Suboxone is a medication widely used in the treatment of opiate addiction. It is a medication composed of different chemical elements, including buprenorphine and naloxone.
This formula has been prescribed for years and is one of the main tools in treating opioid addiction. However, not all insurances will cover this type of treatment, and not all doctors will prescribe it.
Which doctors prescribe Suboxone?
The vast majority of doctors will offer this prescription. It is important to note that this medicine is not available without medical authorization.
It is a medication used for the treatment of opioid addiction and the management of anxiety.
According to legislation, opioid addiction is a substance abuse disorder. That means that insurance plans, e.g. Medicare, may not accept a claim for a prescription if a doctor who can guarantee coverage has not been consulted and authorized.
If you are not clear about the services or how to access such a prescription, it is good to contact the Substance Abuse and Mental Health Services Administration at 1-800-662-4357. This telephone number is available 24 hours a day, every day, throughout the year.
Checking your health insurance and its coverages
That is critical before you apply for any medication or medical review. You have two options if you are struggling with opioid addiction and want to know whether or not your insurance covers you.
The quickest would be to go directly to the particular conditions of your insurance policy. This is the most efficient and fastest way to consult the possible modifications made according to legislative advances in many cases in real-time. Also, sometimes the insurers themselves make some modifications to which you may not have had access.
Another formula would be to contact one of the associations or public entities to treat addictions. Through these entities, you can access information on insurance coverage. However, this information will not always be 100% up to date.
Do all insurances cover Subutex treatment?
Indeed, most health insurances, including the most relevant ones, will offer coverage for opioid treatment and addiction with Subutex or similar formulations.
However, as noted above, this requires some preconditions. The first is a medical authorization. Therefore, it is important to find doctors who treat this type of condition and who will write such prescriptions. Although many doctors can do this, not all of them do.
After locating the doctor and obtaining authorization and prescription, most insurance providers will authorize the coverages reflected in the policy.
On the other hand, both Medicaid and Medicare will cover opiate addiction treatment. That also includes Suboxone treatments. However, prior authorization will also be required in most states, at least in the case of Medicaid.
How much does Suboxone treatment cost?
The cost of these treatments varies depending on two elements:
- The type of insurance: generally, the insurance will offer you a co-payment. Not all policies provide the same coverage. In some cases, it will be a fixed amount, and in other cases, a percentage of the cost of the medicine.
- The type of treatment: depends on the treatment. The fee may be higher or lower. Not everyone needs the same amount. On the other hand, it will also depend on the brand of the product. Generics are cheaper than own-brand products.
The price range is really wide. It can range (without insurance contribution) from $170 per month to $580 per month for the branded medicine. For generic brands, this is reduced to between $60 and $200.
It should be borne in mind that the amount of medication to be taken daily varies depending on the treatment and the previous medical prescription.
Finally, accessing financial assistance programs should also be considered if treatment is unaffordable. Variable cost funding is present in many addiction treatment centers.
In the case of not being able to afford to pay for the medication in full or not having prior insurance coverage, it can consider this type of financial assistance from the detoxification centers themselves.