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Does insurance cover Suboxone treatments?

Coverage for Suboxone varies based on insurance, and the best way to find out is to contact your insurance company. Generally speaking, though:

  • When it comes to private insurance companies, many DO cover Suboxone, as long as a physician deems it is medically necessary. Some insurance companies require a prior authorization request in which the provider must submit a form to get Suboxone approved before prescribing it. Some insurance companies also dictate the formulation (generic versus brand-name) and whether they will cover films versus tablets. They also might specify a maximum daily dose and length of treatment. Patients will also likely be charged a copay based on their plan.
  • Medicare and Medicaid typically DO cover Suboxone. Depending on the state, Medicaid coverage may or may not require a prior authorization request before a doctor can prescribe it.
  • If you do NOT have any insurance coverage, the cost can vary based on the prescribed dose. A one-month supply of brand-name Suboxone could cost between $166-$570 while the generic could cost between $60-$200.  

Patients unable to afford Suboxone (regardless of insurance coverage) can apply for cost-assistance. The company that makes Suboxone offers this type of program to help reduce out-of-pocket expenses. To learn more, go to: inSupport program.

Randi Sokol, MD, MPH, MMedEd

Randi Sokol, MD, MPH, MMedEd, is an Assistant Professor at the Tufts Family Medicine Residency Program and Instructor at Harvard Medical School. She is Board Certified in both Family Medicine and Addiction Medicine. She earned her B.A. at the University of Pennsylvania, her Medical Degree and Masters in Public Health from Tulane University, completed Family Medicine Residency at UC-Davis, and earned a Masters in Medical Education through the University of Dundee.

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