Does State-Provided Insurance Cover Suboxone? For How Long?

If your health insurance coverage is with Medicaid, then you may have questions regarding their Suboxone coverage for opioid recovery. Though buprenorphine coverage can change occasionally, the basic coverage has stayed pretty much the same for some time now.

Below are additional coverage guidelines not published in our previous articles.

Does Medicaid Cover Suboxone?
They will cover generic tablets, but not the original Suboxone sublingual films.

Does Medicaid Cover Subutex?
Yes, but only in specific cases:

  • Women who are pregnant
  • Women in the first three months of breast feeding

How Long will Medicaid Cover Buprenorphine?
Medicaid will cover up to 16mg daily for up to six months, but then requires another prior authorization and most likely notes from your physician.

Is Bunavail the Same as Suboxone?
Bunavail buccal film contains 4.2mg of buprenorphine and 0.7mg of naloxone. According to the manufacturer, Bunavail’s efficacy is the same as Suboxone 8mg / 2mg sublingual films due to its buccal delivery mechanism.

Do People Like Bunavail as Much as Suboxone?
The opinions differ person to person. The most common comment we hear about Bunavail is that it takes a long time to dissolve, making some people wonder if the buccal film has to fully-dissolve before all of the medication has been delivered. According to the Bunavail frequently asked questions website for physicians, patients are supposed to allow Bunavail to fully-dissolve in order to receive 100% of the medication.

How Do I Get Medicaid to Pay for My Bunavail?
Medicaid requires that your recovery clinic or physician file a prior authorization. If you are planning to become a patient at Nashville Recovery you can submit your Medicaid insurance information prior to your visit, so your generic tablets are pre-approved and ready at the pharmacy following your visit.

Click here to begin your prior authorization

Still Have Questions? Check Directly with Medicaid
The information provided on this page is for entertainment purposes only, and may be out of date. Be sure to contact Medicaid directly for the most up to date buprenorphine coverage and guidelines. There is a phone number on the back of your insurance card that will put you in contact with them.

As always, Stay Clean 🙂

1 Comment

  1. Michelle Devine on December 1, 2020 at 9:25 am

    Who can get TNCare? U have to b deaf, blind,or have breast cancer or have a minor child. Even crazy ppl can’t get Tncare. I saw my cousin in the very last stages of cirrhosis the folks at tn care kept declining her. Tncare isn’t based on how sick u r, it’s based more on ur position in the family. IE, minor children that r fatherless will get u Tncare in a snap. Cirrhosis isn’t a big deal even though u cook b4 u die, but breast cancer is another fast approval. Um? Thought health insurance provided by the government was for all the sick folks with any deadly disease. But cirrhosis comes with a stigma I guess.

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