Why Will Some Health Insurances Cover Naltrexone But Not Vivitrol?

If you are thinking about getting medical insurance or switching providers then you need to do your research first.

It is important to get an insurance plan that covers the types of treatment and medications that are relevant to you and will meet your needs going forward. 

Why Will Some Health Insurances Cover Naltrexone But Not Vivitrol?

Some insurance providers will only cover certain types of medication and not others.

For example, there is a lot more chance of a health insurance provider covering naltrexone but not vivitrol- but why? What is the difference between the two medications? And why is one covered more often than the other? 

We have put together this information to tell you everything that you need to know. Keep reading to find out more. 

What Is Naltrexone?

Naltrexone is an opioid antagonist that works by blocking the effects of opioids in the brain.

This means it can help people who suffer from opioid use disorder (OUD) as well as those with co-occurring disorders like anxiety, depression, and addiction to alcohol or benzodiazepines.

The drug was approved for OUD by the FDA in 2002 and has been used since then. However, it is still considered to be experimental because of its side effects.

How Does Vivitrol Work?

Vivitrol is a long-acting injectable form of naltrexone. It works by binding to receptors on nerve cells in the brain.

When the body binds to these receptors, it blocks the action of naturally occurring opioids in the brain.

As a result, the person feels less pleasure when they take drugs. In addition, vivitrol helps reduce cravings for opioids.

Is Vivitrol Effective?

Vivitrol is effective at treating OUD. A study published in 2017 found that patients treated with vivitrol experienced significant reductions in their heroin use compared to placebo.

Another study showed that vivitrol reduced the number of days that participants were high during the previous month.

These results suggest that vivitrol may be an effective way to treat OUD.

However, there are also several studies showing that vivitrol does not work as well as methadone. One study found that vivitrol did not decrease opioid use as much as methadone.

Another study found that vivitol did not improve outcomes after 12 months of treatment. Finally, another study found that vivi­trol did not affect reducing opioid use.

These findings show that vivitrol is not always effective in treating OUD. People should talk to their doctor before starting vivitrol if they are considering using it. They should also discuss whether vivitrol would be right for them.

Why Are Some Insurance Providers Covering Naltrexone But Not Vivitrol?

There are many reasons why some insurance companies cover naltrexone while others don’t.

Some insurers simply prefer one type of treatment over another. Others believe that naltrexone is more effective than vivitrol.

Still, others think that vivitrol doesn’t offer enough benefits to justify coverage.

Whatever the reason, it is important to understand what each medication offers so you can make the best decision about which one to choose.

If your insurance company covers naltrexone but won’t pay for vivitrol, ask why. You might be able to get the same coverage for vivitrol through another insurer.

If your insurance company covers vivitrol but won’t cover naltrexone, ask why. You could try asking your doctor to write a letter explaining why he thinks vivitrol is better than naltrexone.

Your doctor could also contact your insurance provider directly to see if they have any concerns.

What Is the Difference Between Naltrexone and Vivitrol?

Both naltrexone and vivitrol are medications that block the effects of opioids in your brain. However, they do this in different ways. Naltrexone attaches itself to opioid receptors in the brain. This prevents the body from feeling the effects of opioids. 

Vivitrol is a long-acting version of naltrexone that stays in the body longer. It works by attaching to opioid receptors in the body.

The attached receptor then stops the body from producing its opioids.

How Do I Know Which Treatment Works Best For Me?

The first step when choosing between these two treatments is deciding how severe your addiction is.

If you have recently relapsed or are struggling to stay clean, naltrexone may be the better choice.

If you feel like you are ready to stop taking opioids completely, vivitrol may help.

The next step is figuring out which treatment fits your lifestyle. Both naltrexone and Vivi­trol are taken once per day.

However, vivitrol comes in a liquid form that needs to be injected under the skin. Injections are less convenient than oral pills.

Naltrexone has fewer side effects than vivitrol, although both have potential risks.

Side effects include nausea, vomiting, dizziness, headache, diarrhea, constipation, and stomach pain.

These side effects usually go away within a few days.

Vivitrol has a higher risk of liver damage than naltrexone, although this is rare. Other possible side effects include depression, anxiety, weight gain, insomnia, and decreased sex drive.

Which One Should I Choose?

It depends on your situation. If you have recently stopped taking opioids and need to stay off them for a while, naltrexone is probably the right choice.

Vivitrol is an option if you want to take advantage of all the benefits offered by extended-release naltrexone.

You should talk with your doctor before making a final decision. He or she can explain the pros and cons of each medication and help you decide which one is best for you.

I am currently on Suboxone and my insurance does not cover it. Are there other options?

Suboxone (buprenorphine) is a combination of buprenorphine and naloxone. Buprenorphine is used to treat opiate addictions and naloxone blocks the effects of heroin and oxycodone.

Although Suboxone costs more than generic versions of naltrexone and buprenorphine, it is covered by most private insurance plans.

If you don’t have insurance coverage, you might consider buying Suboxone online. Some pharmacies sell Suboxone without a prescription.


Naltrexone and Vivitrol are similar but they aren’t the same. This is why it is important to check whether the provider you are considering covers one or both medications.

Ryan Ascroft