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.