Will Insurance Cover Suboxone Detox In Florida?

Detox is the first courageous step in the recovery process. Many detox centers use suboxone to make the withdrawal process safer and more comfortable. Knowing that you will be going through withdrawal causes much fear and anxiety; therefore, the cost of suboxone detox should be your last and least significant concern.

You should not have to sacrifice quality for the sake of price by opting for a lower-quality detox center. The first source that you should turn to for financial help is your health insurance plan. You must contact a representative from your health insurance company to find out your specific coverage for addiction treatment.

Insurance and Treatment

Private health insurance  (PPOs and HMOs) may or may not cover suboxone treatment in total. Factors that can decide coverage include:

  • Medical necessity
  • Whether it covers prescription medications
  • If a co-payment is required
  • If Suboxone is on the plan’s approved medication list

If you bought your healthcare plan on the Healthcare Marketplace as part of the Affordable Care Act, it should cover the cost of a “reasonable” treatment plan. This is particularly true if you meet one or more of the following:

  • A long history of drug abuse
  • Failed attempts at treatment
  • An official diagnosis of psychiatric disorders
  • A complete lack of internal support network

Who Covers Suboxone Treatment?

This is a list of some of the insurance companies that usually cover Suboxone:

  • Blue Cross/Blue Shield
  • Aetna
  • Humana
  • Cigna
  • United Healthcare

What is Usually Covered by Health Insurance?

Health insurance typically covers the following for addiction treatment:

Outpatient Treatment

Insurance plans are typically more amenable to covering outpatient treatment centers than inpatient treatment centers because outpatient treatment centers do not come with the amenities of inpatient treatment centers. 

Though inpatient detox is highly recommended because of the presence of 24/7 medical staff, outpatient detox is an option. Outpatient detox consists of medical staff coming to your home or you going to the detox center and then going home.

If the detox center prescribes suboxone, you will be given suboxone to take at home or before you go home. Outpatient treatment allows you to carry on with work, school, and family responsibilities while still receiving a high level of care.

In-State Treatment Centers

Though out-of-state treatment centers are preferable because they allow you to get away from relapse triggers, have more privacy, and make it harder for you to give up, in-state treatment centers are more likely to be covered by health insurance.

You can turn to the internet to find quality suboxone detox centers in your state. Health insurance plans typically have a list of their in-network providers, which are typically treatment centers that are in your state. 

Treatment plans will address the relapse triggers you may have during therapy sessions. Aftercare treatment allows you to continue your recovery through 12-step groups like Alcoholics Anonymous, Narcotics Anonymous, and other self-help groups.

A Percentage of Treatment

Most health insurance plans only cover a certain percentage of addiction treatment. The percentage can be less than half or more than half. Some health insurance plans may not cover any percentage of addiction treatment your deductible is met.

You can call a representative or check your health insurance plan’s website for percentages that are covered. Many people choose to pay for treatment and medications themselves to keep their conditions private.

The ACA

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that buprenorphine and MAT are usually covered by insurance. In addition, the Affordable Care Act (ACA) requires that treatment for addiction and behavioral health care services are to be covered by most major health insurance plans. Policies and coverage will be modified slightly by the insurance plan you buy, the state, and the insurer.

The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 requires insurers to provide the same level of benefits for behavioral health services, like addiction treatment, that they provide for primary care.

The entire cost of Suboxone may not be totally covered. There may be provisions regulating how many refills you can get and how often. Your plan may require that you get the generic version of Suboxone.

Suboxone Treatment

Although Suboxone is a medication, Suboxone treatment usually includes:

  • Counseling services
  • Office visits
  • Laboratory testing and analysis
  • Detoxification services

It’s important to check directly with your individual health insurance policy and the insurance company to find out if Suboxone treatment is covered and the amount.

Thirty Days of Treatment

Studies show that 90 or more days of inpatient treatment produces the highest success rates. However, health insurance plans tend to cover only 30 days of treatment because that is the amount of time it takes for the addictive substances to be completely detoxified from your system. If the staff determines that you absolutely need more than thirty days of treatment, your insurance may cover it.

What Is Suboxone?

Suboxone is a drug that is commonly used in medication-assisted treatment and detox of opiate addiction. The active ingredients in Suboxone are buprenorphine and naloxone. The buprenorphine is the opiate substitute, and the naloxone prevents you from feeling the psychological effects of the opiate.

Buprenorphine is an opioid drug but doesn’t interact as much with brain chemistry and opioid receptors as much. It acts as an antagonist by poorly fitting the opioid receptors to block the feelings of euphoria and suppression of the respiratory system and to prevent other opiates (e.g. heroin) from attaching to the receptors. 

Naloxone also works by acting as an antagonist to block the full effects of the opiate and to prevent other opiates from attaching to the opioid receptors. If you use heroin or any other opiate while on suboxone, you will not feel any effects because the receptors are blocked. Suboxone can be taken by a film that is placed on the skin or in pill form.

Suboxone is typically used as part of a medication-assisted treatment program. Medications like Suboxone are used on a long-term basis to promote treatment acceptance and recovery.

You can receive suboxone at any detox center or rehab center that offers suboxone as part of their treatment. If you want to use suboxone for medication-assisted treatment, you will need to go to a clinic that offers suboxone for outpatient patients. The cost of suboxone includes doctor’s visits and the drug itself.

Adding Up the Cost

The cost of the drug can range between $180 to $720. The cost of the initial doctor’s visit can be around $300. The follow-up visits can cost approximately $200. Suboxone is priced in 2-milligram doses at $3-$4 per dose and 8-milligram doses at $6-$8 per dose.

A standard dose can be between 8 and 24 milligrams per day when starting on a buprenorphine treatment plan. Costs of Suboxone add up quickly because several doses are often needed every day to help with the cravings and withdrawal symptoms. 

Health insurance and assistance programs can help with the cost.  For people with private insurance coverage, Medicare, or Medicaid, the price could be notably lower. Medicare does not usually cover the cost of prescription medication for outpatient treatment. 

However, it can cover the cost of Suboxone treatment if it is part of an inpatient or emergency treatment plan. This may happen if the Medicare-certified treatment center had Suboxone listed as an eligible medication and the patient received treatment at that facility.

According to SAMHSA, Medicaid is one of the largest single-payers of medications for treating substance use disorders (SUD). The coverage varies from state-to-state and may depend on whether the state’s Medicaid plan is under a “managed care” or HMO arrangements. Florida Medicaid covers Suboxone under FFS plans with some limitations:

  • Patients are required to be enrolled in or have documented proof of SUD counseling.
  • Patients must be 16 or older.
  • There is a maximum dosage of 32mg per day.

An FFS (fee for service) plan is one in which Medicaid will pay the provider directly for each covered service.

Do not settle on Subutex, which is a generic form of suboxone, because it does not contain naloxone, which is needed to prevent psychological dependence.

Suboxone Savings Card

Suboxone savings cards can help eligible patients pay as little as $5 each month for Suboxone Film. People without insurance can also get the savings card and save between $86 to $230 monthly. Suboxone Film is a thin film strip that is taken by placing the film under your tongue or inside your cheek.

Other Treatments Used in Detox

While medication plays a major role in making detox safe and comfortable, a variety of other methods are used in detox. An effective detox center will take a holistic approach to treating withdrawal. 

Massage therapy can help to treat body aches, poor circulation, emotional distress, insomnia, and digestive issues. Chiropractic care can help to alleviate stress and tension, promote detoxification, and elevate mood. Acupuncture can send a healthy flow of circulation throughout the body to treat a variety of ailments.

Also, prolonged drug and alcohol use can deplete the body and mind of vital nutrients it needs to be healthy. So, many detox centers carefully plan the meals to ensure that you are receiving nutritious, delicious meals. 

Withdrawal does not only present physiological symptoms; it also presents psychological symptoms (e.g. depression, anxiety, and insomnia). Though detox centers’ primary goal is to treat physiological symptoms, they often have counselors to help clients work through the psychological symptoms. Withdrawal symptoms from some drugs can cause psychosis and deep depression that can lead to suicide. This is why detoxing with medical supervision is so important.

Modern technology makes the detox process even safer and more comfortable. Biosound therapy uses soundwaves from beats and music to treat the psychological symptoms of withdrawal.

Far Infrared Sauna uses infrared waves to encourage the body to detoxify itself of the addictive substance and other toxins. Cold laser therapy uses a painless beam of cold light on target areas to trigger the release of endorphins, reduce drug cravings, and mitigate other withdrawal symptoms.

Contact Coastal Detox Today!

Coastal Detox is a Joint Commission Accredited detox facility that is located in Stuart, Florida. We help people sail through detox from alcohol, opiates, and other drugs through their use of both medical and holistic treatments. Our stunning facility that is located on Florida’s Treasure Coast provides a beautiful place to heal. Most major health insurance plans are accepted.

If you are interested in Coastal Detox to sail through detox, contact us here. We are waiting for your call!

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    9/19/2018
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