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Message Board > Heroin > Healthcare In Us That Covers Suboxone?


Posted by: devangreb2 March 18, 2014, 11:54 PM
Does anyone know of a Healthcare plan in the US that covers at least some of the cost of suboxone? My son can't afford Healthcare insurance because he's paying so much for the sub!

Thanks!
Susan


Posted by: Granny2 3 March 25, 2014, 6:55 PM
Susan,
sorry it took me so long to get back to you,

I have Anthem Blue Cross and they now will treat addiction and now they even cover methadone maintenance. It is covered under their Mental Health and Substance Abuse (chemical dependency) Services. You will need to check further into how that works but it may be something that can help.

Good luck!

granny

Posted by: devangreb2 March 28, 2014, 10:40 PM
Thanks so much for the reply, Granny! Here's what I found...


Posts: 5939
Joined: April 17, 2005



On Healthcare.gov I found a policy that will cost my son about $225/month. (I wasn't able to get an actual quote for a smoker because they don't post that on the site). There is no deductible to be met for prescriptions, and the co-pay is just $45/month for a month supply. It is through Highmark and the plan is called Flex Blue PPO 1000 Community Blue Plan. With what he was paying for suboxone and his doctor visit per month, he will be paying about the same amount and getting health coverage. This is GREAT because he has been letting some of his health issues go because of money.

Another GREAT thing about it is they can't refuse you for pre-existing!!!!

I hope this helps others in the same predictament. Please verify the information before you take out a plan, but this is what I was told on live chat with Highmark.




Posted by: Granny2 3 March 29, 2014, 8:49 PM
Hey Susan,
I am glad you were able to find something that helps your son, and it sounds like he'll have a lot more than he asked for! Very cool.

My insurance ,just for ME is like $650. but I did not tell my insurance about my addiction because I knew they would charge me up the ying yang. BIG MISTAKE, but I cant change it now. Too bad because they would totally pay for my MMT.
I was told by numerous people to tell them when I applied (April 2012) and I didn't.
To make a long story short make sure when ANYONE applies for insurance be honest about any meds you are on too. Back when I applied none of the companies dealt with addiction related issues so it is great to see it now.

Posted by: devangreb2 March 30, 2014, 2:34 PM
The ONE good thing that came from National Healthcare is that they can't refuse to cover you due to a pre-existing condition and they can't charge you an arm and a leg because of it either. They do, however, ask if you smoke, which he does, and it only increased his from $225/mo to $229.63/mo. There were cheaper ones, but the deductible was higher and he doesn't have the reserves to get him to the deductible, so we were very pleased to get this one! It only has $1,000 deductible (the lowest available). He will probably be putting out a tiny bit less than he was with paying for his doctor and suboxone (and his pharmacist was giving him the BEST POSSIBLE price because he likes my son and wanted to help him), and he has gained having security of knowing that if he has to go to the hospital (God forbid) that he won't be charged $4,000! His suboxone will cost him $45/month and his doctor will now cody him $25 instead of $60! We're VERY pleased! :)

Posted by: devangreb2 March 30, 2014, 2:39 PM
P.S. The website is Healthcare.gov and you can check out the plans there very easily

Because of the March 31st deadline, both the website and phones are OVERLOADED!!!! I finally got through on the phone and the girl who assisted me was VERY PLEASANT and VERY HELPFUL (Ebony Jones). She told me that at time I called, there were 6,000 calls on hold!!!! I had to hold for over 30 minutes to get through. it couldn't hurt to see if you qualify if it could save you some money. There is assistance/reduced payments for people who qualify financially.

Posted by: Suboxman March 30, 2014, 3:03 PM
Susan? Forget my Politics aside. Please make sure YOU read the entire policy AND is it in your name or your son? The government will tell you anything you want to hear but reality is unless you meet certain requirements the cost is ?? Whatever eases the stress of not having Insurance is key--Also Medicaid medicare advantage and medicare are three different animals--Susan if you did sign for affordable care or any insurance GET PROOF that you paid for it COPY OF YIOUR CHECK--and your networks of doctors and network/Preffered for medications--Its confusing but we have to do whatever is in front of us TODAY--it will get better --

Hope things are cool--Jeff

PS--There is no deadline anymore Susan----Thats the 38th change of OBAMACARE--LOL--

Posted by: Granny2 3 March 30, 2014, 11:19 PM
hey susan,
My insurance is so expensive because of my age I'd guess...I will be 61 in June. I had anthem since 2012, started at 640 and it went up and down like 4 times now I'm back at $600.+
Good for your son to get such a great price!!!

Posted by: Nancy September 10, 2014, 10:50 PM
try Humana, but you have to have prior authorization every month!

Posted by: Little Sisiter November 25, 2014, 12:53 PM
Hi Ladies! I just now ran across your posts and wanted to let you know that there are Suboxone Coupons you can find online that my Safeway Pharmacy in WA State accepts with no problem. I pay $25 a month for #60 of the 8/2 mg strips. The coupons are valid for 6 months.

I too have Anthem Blue Cross of Washington; my Psychiatrist, after insurance pays him charges a copay of $38.00. I've been seeing him now for about 5 years, but now that the pre-existing clause is not a problem, maybe the coupons will work for you, too. The Doc may have access to the coupons as well, or can request some for his patients.

Good luck to you! it was a real life-saver for me; and the coupons make it so I can eat! :)

Posted by: Becca January 3, 2015, 6:06 AM
I have Insurance through my job that doesn't pay for my medicine at all or the doctor visit. I need help! I'm paying full price for my medicine plus $28o for the visit. I'm broke every month and I don't know what to do bc I need my medicine. It's helped me turn my life around except for the fact my broke every month. I have cvs caremark through my job and they stopped paying January 2014. They want my doctor to prescribed the generic zubsolv. My doctor doesnt and won't prescribe the generic so I'm screwed. What can I do?!? What Insurance will pay for suboxone?

Posted by: Papa Bear January 3, 2015, 10:46 AM
Becca:

Are you attending NA meetings?

Bob

Posted by: devangreb2 January 6, 2015, 9:31 PM
Thanks all for your posts!

I don't know where you are Becca, but my son's healthcare coverage - Highmark Blue Shield Flex Blue 1000 Plan has been WONDERFUL! There is a $45 co-pay for a month's supply of suboxone, and so with the $60/month coupon he gets it FREE!!!! So he's paying less for his healthcare than he paid per month for the suboxone, and he now has healthcare! Thank God for that because he had a hernia and recently (December) had surgery on that!

Good luck!
Susan

Posted by: cara February 12, 2015, 1:28 AM
I think if you were "allergic" to all of the generic meds your insurance would have to pay for the only one you don't have an allergy to. Do you get what I'm saying here?

Posted by: jamiecurious February 13, 2015, 1:30 PM
This is to little sister, can you tell me where to get the coupon, I recently had an insurance prescription plan change he at work cvs caremark and they wont cover the strips at all, They pushed me to subzolv and it sucks and is more expensive.. I would really appreciate the chance to talk to you more about it.


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Posted by: Pete4989 July 27, 2015, 9:55 AM
sent my final Appeal to the final review appeal board few weeks back to cover my suboxone films and thank god I just gotta respond back from them in a letter that they are going to cover the films now,was taking Roxane brand flipping hated it,horrible sick feeling, then zubsolv and was doing nothing in comparison to the films,very thankful,not sure what my copay is going to be probobaly around 40$

Posted by: DB November 6, 2015, 5:19 PM
Hi, can anyone recommend a plan to cover suboxone in Northern California? All the insurance plans have changed for 2016 and we are so confused as to which one can give us the best value to cover the cost of the monthly supply without all the headaches of every 3 months testing required for my 26 yo. Thanks for the help.

Posted by: OpiateLuvr November 11, 2015, 9:52 PM
Wow......
you guys are SO lucky... Here in Massachusetts- all insurance is incredibly expensive. My partner is on COBRA right now (which is just a temporary thing until your permanent insurance gets into place) and we pay $799/month just for him. And- that's only half payment, his company is paying the other half. He'll be switching over to Medicare but not for another six to seven months so this is the interim coverage. They don't cover any mental / addiction issues as it is just a temporary bridge type of thing- but still. For eight hundy a month, I feel like it really oughta come out and do my windows too... Know what I mean?

Wishing all the best to Susan & Granny and all the others here too- and hoping that you get what you need. It's so incredibly important when someone finally comes to the realization that they need help- that they are actually ABLE to get it. I'm so sincerely glad we've got a place like this where we can all find each other and commiserate like this about things that the "general public" either would frown upon or we'd be totally misunderstood for something else. I'm so pleased and happy that a site like this EVEN exists where "Like" can find "Like" and there is no judgment and no shade being thrown on anyone. I say Huzzah to this site as it's helped so many already and is doing the same for me and many others I know... I am so very happy & blessed to have this resource at my fingertips and am so pleased to meet new friends (partners in crime (if u will :-)). MUAH!
OL

Posted by: mike January 29, 2016, 8:48 PM
I just got a script filled in Illinois for 8mg suboxone I have madicaid insurance threw the state when I droped it off the pharmacist said he has 4 others with state insurance and they have never been filled through insurance. My Dr said we would have to do a lot of foot work and hopefully get insurance to pay well anyway 2days after I turned it in I called to see if they could work with me until insurance approval and they said it was already approved from my insurance to come pick it up there was a 3$ copay. maybe somethings changed the beginning of the year Hope others find a way to get what they need to stay healthy at reasonable price

Posted by: ozemaarnold March 8, 2016, 11:31 PM
I'm trying to find insurance that covers this the insurance I have doesn't cover it because the doctor himself doesn't accept blue cross blue shield of MS. So how can I find insurance that covers this.

Posted by: bearybad May 2, 2016, 2:45 AM
BHG knoxville, TN charges $200 cash per month for treatment with Suboxone. BlueCross/BlueShield pays for the prescription if you are in Tennessee. They will admit an addict to the program the very first day you call. I got my Suboxone free for 8 months with that insurance. It saved my life. Also, a friend of mine went to Fort Sanders pain clinic (a legitimate pain clinic) and was covered by BlueCross/BlueShield, and got Suboxone. Tennessee is one of the most non-understanding states when it comes to addiction. We're in the Bible Belt. But BC/BS does cover detox and subsequent treatment with Suboxone. Blessings to you. Peace.

Posted by: penguin May 23, 2016, 1:07 PM
I've been on suboxone strips for a few months now & my insurance was covering it I only had to pay $4 copay each month but the Dr doesn't accept my insurance so I'm paying almost $300 a month just for the visit. I went to get my prescription filled Friday & the pharmacist said my insurance has rejected to pay for it because it only covers a certain amount in 180 days I went back to the dr to let them know I couldn't get my script & they said they must need a prior authorization & to ask for an emergency supply well my insurance denied the emergency supply & the girl at the dr office told me to buy some until they get it figured out it costs almost as much at the pharmacy as they do on the street which is ridiculous & I could never afford to pay almost $800 a month for medicine. I just wanted to know if anyone ever had this type of problem before & how long does it usually take to resolve? I only have a few left from what I was able to afford to buy out of pocket & haven't heard anything from my Dr office yet. Will they really just cut you off completely even if you need these strips to function & live a semi-normal life?

Posted by: OpiateLuvr June 4, 2016, 1:05 AM
I just found out that MassHealth does not cover Suboxone at all -unless there is a child under 5 in the home. Once a child ages over 5, all subox coverage stops. This doesn't make sense and I'm not sure why this is how it is here..... Doctors here say this:

More puzzling is that this refusal comes in a state that has the most progressive health care system in the country, one that ensures that virtually every citizen has access to medical care. MassHealth’s refusal to make Suboxone film available to the poorest, most vulnerable people in Massachusetts represents a gaping hole in the safety net.

I don't understand it either- but right now thats the law.

Posted by: James July 27, 2016, 9:40 PM
I have blue advantage here in Littlerock ark I pay $300 month and my employer pays the rest. My co pay on 120. 8mg sub film. $30. For some reason they don't pay my doc visit though. $300 first visit. Come bk in a week at no charge to see how sub is doing. Then come once a month for refill. $240.00 doc out of my pocket. Then $30 for my subs. So much better than blowing all my money to keep from withdraws. I love the subs. I beleave they saving my life. Only been on then 2 weeks now. If I'm not carful I'll be hooked on them too. Please if anyone knows a rememidy to easy off subs too. Please tell me all you know?

Posted by: matt September 27, 2016, 11:07 AM
Doctors normally do not accept insurance to see patients for Suboxone. That has been my experience. You can submit after the fact to your insurance but getting the full amount of money back is a pain. Such a corrupt practice that these doctors care so much to help, but you have to pay them cash even though you are insured and they are in that providers network

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