Suboxone is a prescription drug used to treat opioid addiction. If you or someone you love has a history of opioid abuse, they might qualify for coverage under their health insurance plan with Aetna.
Suboxone is a combination of buprenorphine and naloxone. The two drugs are combined into one pill that helps patients manage withdrawal symptoms and cravings.
Buprenorphine is a partial opioid agonist (meaning it acts on some receptors) and naloxone is an antagonist (meaning it blocks other receptors).
This means that suboxone can reduce cravings for opioids without causing euphoria or sedation. This article will discuss whether Aetna covers prescriptions for suboxone.
What Is Aetna?
Aetna is the nation’s third-largest insurer. It offers private and public plans through employer-sponsored group plans, individual policies, Medicare Advantage plans, and Medicaid programs.
In addition, Aetna provides services including medical management, pharmacy benefits management, health information technology, and data analytics.
What Is Suboxone?
Suboxone is prescribed by doctors as part of treatment for opioid dependence. It contains buprenorphine, which is a partial opioid agonist, and naloxone, which is an opioid receptor blocker.
How Does Suboxone Work?
Suboxone works in several ways:
- It reduces cravings for opioids
- It reduces the likelihood of overdose from using heroin or another opioid
- It reduces the risk of relapse after detoxification
How Is Suboxone Prescribed?
The FDA approved Suboxone in 2002. Doctors prescribe it to help people who have developed a physical dependence on opioids and need long-term treatment. They also use it to prevent opioid overdoses.
Doctors typically start patients on low doses of suboxone and gradually increase them over time.
Patients may be able to take suboxone daily or just once per day.
Who Can Get Coverage For Suboxone?
If your doctor prescribes suboxone for you, he or she must submit a request to Aetna to get approval. You should ask your doctor about this process before starting treatment.
If you already have a prescription for suboxone but don’t know if your plan covers it, contact your provider.
Some plans cover specific medications, while others provide blanket coverage for all covered substances.
Are There Side Effects Of Suboxone?
Side effects of suboxone include nausea, vomiting, dizziness, drowsiness, constipation, dry mouth, sweating, and headaches.
These side effects usually go away when patients stop taking the medication.
Can I Take Other Medications With Suboxone?
Yes. Your doctor may recommend that you take other medications at the same time as suboxone. Examples include antidepressants, antihistamines, anti-anxiety medications, and sleep aids.
Does Aetna Cover Prescriptions For Suboxone?
Some states require insurers to offer coverage for certain medications. However, there is no federal requirement that all insurance companies must provide coverage for every medication.
If your state requires coverage for suboxone, then Aetna should be able to approve your request. You can contact them directly at 1-800-827-1400.
If your state does not require coverage for suboxone and you have a history of an opioid use disorder, you may still be eligible for coverage.
Your doctor may prescribe suboxone as part of a treatment plan.
How To Apply For Aetna Insurance Cover
You can apply online by visiting www.aetna.com/apply/. If you prefer, you can call Aetna customer service at 1-800-AETNA (1-800-238-6282).
What Happens After My Application Is Approved?
Once your application has been approved, you will receive a letter confirming your eligibility for coverage.
You will also receive a form called “Your Plan Summary Card” with information about your plan benefits.
This card is important because it tells you what services are covered under your plan. It also lets you see any restrictions or limitations that might affect your coverage.
How Much Will I Have To Pay Out Of Pocket For Suboxone?
Suboxone costs $50-$100 per month depending on your plan. The cost varies from one plan to another. Contact your health care provider to find out more details.
Will I Be Able To Receive Suboxone At No Cost?
There are many ways to get free access to suboxone. Some examples include Medicaid, Medicare, Tricare, Veterans Affairs, military bases, and public hospitals.
If you qualify for these programs, you won’t pay anything out of pocket for suboxone. However, some plans do charge copays and deductibles.
Many insurance providers offer free access to suboxone. They do so through their programs and partnerships with community organizations.
For example, Anthem Blue Cross offers free access to suboxone through its Community Health Network program. In addition, Cigna provides free access to suboxone through its Partnership for Patients initiative.
Alternatives To Suboxone
In some cases, your doctor may suggest alternative methods of treating opioid addiction. Some examples include:
- Methadone maintenance therapy – this involves taking methadone in place of heroin. Methadone is an opiate used to treat opioid addiction.
- Naltrexone implantation – this involves injecting naltrexone into the body. Naltrexone blocks the effect of opioids.
Other Treatment Options For Addiction
The following treatments are often recommended for patients who don’t want to take suboxone. These options include behavioral therapies, support groups, counseling, and other types of psychotherapy.
This type of treatment helps people change their behaviors and develop new habits.
Behavioral therapy includes things like cognitive behavioral therapy, dialectical behavior therapy, motivational interviewing, and contingency management.
Support groups help people connect with others who are going through similar experiences. They provide emotional support and advice.
Counseling helps people deal with issues such as depression, anxiety, stress, eating disorders, and substance abuse.
Counselors use different techniques to help clients understand themselves better and make healthy changes in their lives.
Psychotherapy is a type of talk therapy that focuses on helping people improve their mental well-being.
Examples of psychotherapies include cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy.
Some alternative treatments can be effective at treating opioid addiction.
These treatments include acupuncture, hypnosis, yoga, meditation, massage therapy, biofeedback, and nutritional supplements.
Aetna can cover suboxone if it is prescribed by a licensed medical professional. You should contact Aetna to learn more about how they cover suboxone and if you are eligible for cover on this prescription.
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