Does Insurance Cover Suboxone Treatment?

Suboxone treatment is a life saving choice for many patients suffering from opioid addiction. Although cost and the question of whether insurance will cover the treatment may be a concern. Luckily, due to the awareness of the opioid epidemic, Suboxone is typically covered under most insurances.

How much does Suboxone cost?

Suboxone can be a very expensive drug when it is not covered with insurance. A dose of 8 mg can cost anywhere from $6 to $8, depending on the pharmacy. Generally, Suboxone usually costs $1 per milligram and a standard dose may range from 8 to 24 mg daily. Therefore, assistance from insurance is helpful when meeting the costs of Suboxone treatment.

Factors such as pharmaceutical manufacturer, insurance, health plan or prescribing clinic, and retail pharmacies contribute to the costs of Suboxone.

Cost of drugs is just one element of treatment that needs to be considered. Additional costs from visiting the doctor’s office should also be taken into account. Where you receive treatment, i.e. a private or public treatment center, is another thing to be considered when cost is a factor.

It is important to note, however, that not all insurance plans cover all medicines available for treatment, and that some plans may limit the number of prescription refills which are covered during medically-assisted treatment.

Will your insurance cover the cost of Suboxone Treatment?

According to the Affordable Care Act, it is now required that most insurers cover addiction treatment benefits. The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, also requires health insurers to provide the same level of benefits for behavioral health services, such as treating dependency that they carry for primary care.

In any case, the important thing to note about Suboxone is that it is indeed covered by most insurance policies as a form of medication treatment for addiction, and, therefore, insurance coverage should not be one of the factors holding back a person from seeking addiction treatment.

In fact, many major insurance companies, such as Aetna, are removing a key barrier for patients seeking medication to treat their opioid addiction. They will stop requiring doctors to seek approval from the insurance company before they prescribe particular medications – such as Suboxone. This makes the process of getting treatment even faster and easier, which may be a crucial factor in the successful treatment of opioid addiction.

In addition to private insurance companies, Suboxone treatment can also be covered under Medicare and Medicaid. Medicare can cover the cost of Suboxone, but may only occur if the Medicare-certified treatment center had Suboxone listed on a eligible medication and the individual received treatment at that facility. Medicaid is actually one of the largest single payers of medications for the treatment of substance abuse and use disorders, according to SAMHSA. The coverage provided by Medicaid can vary state-to-state and may require prior authorization and medical necessity.

 

How to find a Suboxone program that accepts your insurance

To prescribe Suboxone, a doctor must be certified. Individuals seeking Suboxone as a treatment option should call their insurance provider to find a physician or facilities close to them who are certified to prescribe this medication. 

To find Suboxone certified doctors in the Mesa and Phoenix area call McKellips Internal Medicine at (480) 830-1553 to make an appointment or visit our page on Suboxone Treatment Therapy.

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