Medication for addiction treatment (MAT) is the standard of care for addressing opioid use disorder (OUD), and your provider may recommend it for long-term recovery. In combination with counseling and behavioral therapy, medications like Suboxone can successfully treat opioid use disorders (OUDs) and reduce opioid overdose.2 To see if your insurance covers treatment at an American Addiction Center (AAC) facility, reach out to AAC’s compassionate admissions navigators 24/7 at . Let us assist you on your journey to a healthier, happier life.
Suboxone Costs: With and Without Insurance?
What is Suboxone?
Suboxone is the brand name for a combination medication with two actives: buprenorphine and naloxone.1 It’s available as a dissolvable film for sublingual administration.1 Suboxone may be used to treat opioid addiction for individuals who have already started recovery and are planning on continuing treatment.1
Buprenorphine is a partial opioid agonist, meaning it binds to opioid receptors to reverse and block the effects of other opioids to help diminish the effects of physical dependency on opioids, including withdrawal symptoms and cravings.3
Naloxone is a temporary treatment that can help reverse an opioid overdose.4 Though Naloxone is often administered by itself, it’s included in Suboxone to discourage the misuse of buprenorphine.4 Trying to dissolve buprenorphine to be injected or inhaled can result in the rapid onset of withdrawal symptoms.3
What is Suboxone Used For?
Primarily, Suboxone is used in the treatment of opioid use disorders (OUDs).2 Medications like Suboxone may be standard parts of treatment programs, incorporating individual counseling and behavioral therapies that address SUDs as part of a comprehensive addiction treatment plan.2 MAT has proved effective in reducing the need for inpatient detox in individuals with OUDs.2
The combination of buprenorphine and naloxone can help reduce cravings and withdrawal symptoms for people who are addicted to opioids.3 Both medications can help minimize a person’s risk of overdose and relapse by preventing them from experiencing the euphoric sensations associated with opioids. Some individuals might also benefit from Suboxone maintenance treatment in early recovery to avoid relapse.3
Some commonly abused opioids that can be treated with Suboxone include:2
- Codeine.
- Fentanyl.
- Heroin.
- Hydrocodone.
- Oxycodone.
- Tramadol.
How Much Does Suboxone Cost with Insurance?
Although the cost of Suboxone with insurance will vary depending on your benefits, eligible patients may pay as little as $5 per month.1 For patients with insurance, there may be copay assistance programs that could bring the cost of Suboxone down.
In addition, patients with Medicaid also have access to medications approved for the treatment of opioid dependence. Suboxone is included in the list of prescriptions covered by Medicaid.7 Generic versions of Suboxone are also covered.7 The extent covered depends on various factors, including limitations, prior authorizations, and documentation that shows Suboxone is medically necessary.
How Much Does Suboxone Cost Without Insurance?
The exact cost of Suboxone without insurance will depend on a variety of factors. Primarily, prices will differ depending on the provider you obtain your prescription from and whether you receive the generic version.
However, there are payment assistant plans and coupons for eligible patients not using insurance. Eligible patients can save up to $170 each month for Suboxone films through exclusive saving cards.1 Pharmacy, doctors’ offices, and clinics may also provide additional savings opportunities.
Do Suboxone Doctors, Clinics, and Rehab Centers Take Insurance?
Under the Drug Addiction Treatment Act (DATA), prescription use of Suboxone is limited to healthcare providers who have met the qualifying requirements, have notified the Secretary of Health and Human Services (HHS) of their intent to prescribe this medication, and have been assigned an identification number.8 There are approximately 50,000 practitioners authorized to treat opioid dependency with buprenorphine, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).9
After finding an authorized and qualified practitioner, you can inquire about their health insurance policies.
- Doctors: Although suboxone doctors aren’t required to accept health insurance plans, most doctors work with major insurance companies to provide coverage. Contact your insurance provider to find a list of in-network providers who offer Suboxone.
- Clinics: In most cases, insurance providers cover clinic visits. However, you will likely need to pay a deductible or co-payment. It all depends on your insurance coverage.
- Rehab Centers: Many rehab facilities offering MAT services will likely take insurance to cover some or all of the costs associated with treatment. With facilities in California, Florida, Nevada, Rhode Island, and Texas providing Suboxone treatment, call American Addiction Centers at to receive information on treatment options.
How to Find Suboxone Doctors, Clinics, and Rehab Centers Near Me
For more information about Suboxone addiction treatment, you may want to reach out to your doctor. Or you can contact one of our admissions navigators at for the information and support you are searching for as you look for addiction treatment.
There are various treatment programs and strategies available, so don’t give up if the first program you check out doesn’t meet your individual needs. To learn more about the addiction treatment process, click here. There are various rehabs near me that can provide the treatment you need as you begin your path toward sobriety.
Does Insurance Cover Suboxone Treatment?
In 2008, with the Affordable Care Act (ACA), the Mental Health Parity and Addiction Equity Act introduced a new clause that required health insurers and group health plans to provide the same level of benefits for all mental and substance use treatment and services as they do for medical care.5,6
Most health plans are required by law to cover addiction treatment services, including employer-sponsored group health plans and coverage sold in the Health Insurance Marketplace.7 And, although benefits may differ across plans, the parity act requires that health insurance plans provide comparable benefits for mental health and SUDs as those provided for physical health care.7
Health Insurance that Covers Suboxone
The ACA lists drug addiction services as one of the essential health benefits that must be covered by insurance.10 The level of coverage will depend on various factors, including the specifics of your policy.
Sources
- INDIVIOR. (2021). Suboxone (buprenorphine and naloxone) Sublingual Film.
- Substance Abuse and Mental Health Services Administration. (2021). Medication-Assisted Treatment.
- Substance Abuse and Mental Health Services Administration. (2021). Buprenorphine.
- Substance Abuse and Mental Health Services Administration. (2021). Naloxone.
- U.S. Department of Health and Human Services. (2020). Does insurance cover medication for opioid addiction?
- CMS.gov. (n.d.). The Mental Health Parity and Addiction Equity Act (MHPAEA).
- Substance Abuse and Mental Health Services Administration. (2014). Medicaid coverage and financing of medications to treat alcohol and opioid use disorders. HHS Publication No. SMA-14-4854. Rockville, MD: Substance Abuse and Mental Health Services Administration.
- U.S. Food and Drug Administration. (2021). Suboxone: Highlights Of Prescribing Information.
- Substance Abuse and Mental Health Services Administration. (n.d.). Buprenorphine Practitioner Locator.
- Office of National Drug Control Policy. (n.d.). Substance Abuse and the Affordable Care Act.
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Rehabs That May Accept Insurance Insurance
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