why is the insurance not paying for s...

why is the insurance not paying for suboxone?

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idk

London, KY

#1 Nov 17, 2010
can someone tell me whats going on!

“I'm Attracted to Beavers...”

Since: Oct 10

Chuckin Wood

#2 Nov 17, 2010
Check your policy, there is probably a disclaimer that your plan will not cover formulary drugs, or basically that they will only cover the generic equivalent or non patent drugs if a generic is unavailable? And, Suboxone does not come in a generic form? This gets complicated with several levels of drug, all based on their patents and time left on the patent. But a good rule for most prescription plans: if it is one of the drugs you see advertised on TV; you know the ones that cause death and/or anal leakage, you plan probably won’t pay for them.

Another thought, and check your plan (it’s a long shot). But maybe a loop hole for you. You plan will have certain rules surrounding mental health (MH) service. This may also include a deductible that includes prescriptions, and Suboxone may be covered after your MH deductible is met?
most do

Elkhorn City, KY

#4 Nov 18, 2010
Most insurance plans do pay for suboxone. Every so often they have to PO it. Not sure what that means, but it can take up to 3 days. I've never had a problem.
Jane Doe

Concord, NC

#5 Nov 29, 2010
CITIZEN wrote:
I AM SO GLAD IT DONT PAY.PAY FOR YOUR OWM BAD HABITS.TRASH.....
FREAKIN' LOSER! BETTER JUST BE GLAD YOU DON'T HAVE AN ADDICTION... THEN YOU'D BE THINKING ENTIRELY DIFFERENTLY!
Jane Doe

Concord, NC

#6 Nov 29, 2010
I have heard that, thanks to the Obummer Healthcare Bill (aka "Commie Care") that insurance companies are running scared in anticipation of how this ridiculous, unconstitutional Bill will affect their profits. And they are adjusting accordingly, and unusually early in the game. While cutting Medicare dramatically as WELL as private insurance coverage & meds! This unfortunately includes Sub (Suboxone) and other expensive meds.

There was an article on insurance companies refusing to pay anymore for Suboxone treatment. Looks like a lot of people are going to be switching to Methadone now and standing in line at the clinics! Gee, thanks Mr. LOSER President, Harry Reid & Nazi Nancy Pelosi!
please

Thelma, KY

#7 Nov 30, 2010
Jane Doe wrote:
I have heard that, thanks to the Obummer Healthcare Bill (aka "Commie Care") that insurance companies are running scared in anticipation of how this ridiculous, unconstitutional Bill will affect their profits. And they are adjusting accordingly, and unusually early in the game. While cutting Medicare dramatically as WELL as private insurance coverage & meds! This unfortunately includes Sub (Suboxone) and other expensive meds.
There was an article on insurance companies refusing to pay anymore for Suboxone treatment. Looks like a lot of people are going to be switching to Methadone now and standing in line at the clinics! Gee, thanks Mr. LOSER President, Harry Reid & Nazi Nancy Pelosi!
Please post a link to this "article" or was it just something that you heard and are repeating?
why

Pikeville, KY

#8 Nov 30, 2010
why should it pay for someone to trade 1 drug for another. working tax payers already keep those people up. you need to get a job and pay taxes to pay for your own pills.
ignorance is bliss

Ransom, KY

#9 Nov 30, 2010
Some of you had said that your glad it wont pay for out "pills", but do you not realize it still pays for pain and nerve pills? So all the people that are still using pain meds can still get them. But the ones that want help and want to get off them cant because their insurance wont pay for it. I have been on Suboxone for 5 years and it has saved my life. Now I work everyday, pay my bills and am a better person. I tried Methadone but its just like a pain pill to me. I was addicted to it and it would run my life. I think the goverment should have to pay for anyone that needs suboxone. I think it should be free to anyone that would like to change their life for the better. Like I said I work everyday and wouldnt mind for my tax money to go to that type of program. Hell, look around at all the people that claim they have bad backs and draw checks but then work on the side or go huntinhg all the time. Now thats a waste of money!
slickdick

Virgie, KY

#10 Nov 30, 2010
i take suboxone an it an;t nothin but another habit an if u dont believe me just wait until u run out and u will b tryng everything to get u a box so u can get the sickness off u.ones just about as bad as the other,its just u can take one box vs. 3 80s. and it will keep the sick off you all day.
ignorance is bliss

Ransom, KY

#11 Nov 30, 2010
I have been on it for 5 years and there has been days that I havnt had any so Yes, I know how painful it is. They are addictive just as any pill is. My point is you can take one a day, not be high and be able to function as a normal human being. When I was on Oxys I wouldnt work, nor would I get out of bed if I didnt have one. Im not saying Suboxine is a non addictive pill, Im just saying it makes people normal. That is if they want to be normal again. I dont have the will power right now to not take pain pills so I know I have to stay on Suboxine. But I pray one day I will be strong enough to not take anything. But I think anyone will agree that someone on Suboxone is better than someone on Oxys or some other pain pill.
tim

Nashville, TN

#13 Jul 14, 2011
does blue care insurance pay for the suboxone at the pharmacy?
vicious cycle

Thelma, KY

#14 Jul 15, 2011
tim wrote:
does blue care insurance pay for the suboxone at the pharmacy?
If you are on a group plan and have prescription coverage I would think so. If you need to get private insurance and are on suboxone it is an automatic denial (at least Anthem BCBS is an automatic denial). It is interesting that insurance companies will pay all day long for people to stay addicted or dependent upon prescription drugs; but when someone tries to stop the cycle and get medical treatment to get better, then the insurance companies will refuse coverage.

Obama's plan is supposed to end the discrimination in coverge for pre-existing conditions; but that will probably simply raise the rates for everyone. Private insurance is already too high.
U R 4 Real

Watsonville, CA

#15 Jun 12, 2012
CITIZEN wrote:
I AM SO GLAD IT DONT PAY.PAY FOR YOUR OWM BAD HABITS.TRASH.....
First of all, aren't we talking about insurance? Who do you think pays for that? Second, someone wishing to get on suboxone is agreeing with you. They are trying to stop their 'bad habit'. That is exactly why they take suboxone. Third, how do you think an addict pays for their own bad habits? Let me tell you, it generally isn't with their own money. That said, I would commend anyone seeking treatment for addiction, and I would expect the insurance companies to pay for it. Of course that is an issue for another day.
still wondering

Thelma, KY

#16 Jun 13, 2012
U R 4 Real wrote:
<quoted text>
First of all, aren't we talking about insurance? Who do you think pays for that? Second, someone wishing to get on suboxone is agreeing with you. They are trying to stop their 'bad habit'. That is exactly why they take suboxone. Third, how do you think an addict pays for their own bad habits? Let me tell you, it generally isn't with their own money. That said, I would commend anyone seeking treatment for addiction, and I would expect the insurance companies to pay for it. Of course that is an issue for another day.
Right, insurance pays for bariatric surgery (morbid obesity is often from a food addiction) and insurance medication to treat nicotine addiction. These addictions can become serious medical problems and so can opiate addiction.

People originally make a choice to overeat, to smoke or to abuse drugs and it quickly gets out of control. So, can someone tell me what is the difference? If treatment for one addiction is going to be paid for by insurance; then why not pay for all addiction treatments?

All three of these addictions have mental health components which are health problems. If treatment for one addiction is going to be paid for by insurance; then why not pay for all addiction treatments?

And, no, I am not asking from the viewpoint of someone addicted to drugs, but rather that of a person in the medical field.
Family Values

Jonesborough, TN

#17 Jul 8, 2012
CITIZEN wrote:
I AM SO GLAD IT DONT PAY.PAY FOR YOUR OWM BAD HABITS.TRASH.....
It's unfortunate that your types are allowed to live....so far
troubled girl

Jersey City, NJ

#18 Jul 25, 2012
All the sudden after three yrs on suboxone from the same doctor and finally getting my life together. My insurance won't pay anymore. Seriously. I'm trying to do the right things. It is cheaper on insurance and easier to get perks and get high. Since there is no generic for this med.
Ashton

Elkhorn City, KY

#19 Jul 26, 2012
Suboxone is just another pill to become addicted to. No one should have to take it long term. I don't even see why docs can prescribe for years.
soon available

Thelma, KY

#20 Jul 26, 2012
troubled girl wrote:
All the sudden after three yrs on suboxone from the same doctor and finally getting my life together. My insurance won't pay anymore. Seriously. I'm trying to do the right things. It is cheaper on insurance and easier to get perks and get high. Since there is no generic for this med.
A generic will be available in January. In the meantime the drug company has been assuming the total copay cost for patients with insurance. They also used to offer medication free for up to three of a physician's patients.
soon available

Thelma, KY

#21 Jul 26, 2012
Ashton wrote:
Suboxone is just another pill to become addicted to. No one should have to take it long term. I don't even see why docs can prescribe for years.
Addiction to tied to behavior. Those that take suboxone correctly are physically dependent upon the medication, but not addicted. They are undergoing a program of treatment for a diagnosed disease.

Try to stop taking your antidepressant or nerve pill and see how your body responds. You certainly wouldn't suggest that someone stop taking their bp medicine or their medication for diabetes. Why suggest that someone shouldn't have the option to treat their addiction until they no longer need the medication? The good thing is that their physical dependence has an end in sight. Hypertension and diabetes have no cure.
FilmStrip

Salyersville, KY

#22 Jul 28, 2012
soon available wrote:
<quoted text>
A generic will be available in January. In the meantime the drug company has been assuming the total copay cost for patients with insurance. They also used to offer medication free for up to three of a physician's patients.
How do you know there will be a generic available? Just wondering

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