Does Medicaid Covers Suboxone Treatment: Overview & Policies

Medicaid is each state’s public health insurance program for patients deemed low-income (defined as being a particular percent above the national poverty level). Every state Medicaid program is ordered to cover the Suboxone treatment program in some form for the therapy of OUD (Opioid Use Disorder). That said, it is crucial to confirm your range’s specifics and make sure it can be used at a provided facility. Some states cover only specific damages or formulations of the Suboxone treatment program

When analyzing treatment alternatives for an opioid use disorder, discovering if Medicaid covers drugs like Suboxone can be incredibly important. Substance use disorders are familiar across the US. Although many people covered by Medicaid struggle with addiction and substance abuse, not even 5% of Medicaid recipients follow substance abuse treatment annually. MAT (Medication-assisted treatment) programs are summarized as the primary treatment method for opioid use disorders. When an individual is seeking treatment for opioid dependence, it is significant that whatever facility they select offers MAT choices that meet their requirements.

Medicaid Coverage For Suboxone Treatment

While the federal government commands all states to give Suboxone for OUD, the precise formulation and amount of Suboxone may differ between states based on the laws of that state’s Medicaid program. Almost twelve percent of Medicaid beneficiaries have a SUD (substance use disorder) of some kind, comprising OUD. Opioid use disorder can be treated with Suboxone.

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What Is Suboxone?

Suboxone includes two active ingredients that are buprenorphine and Naloxone. Buprenorphine is a partial opioid agonist, and its properties are long-lasting. When buprenorphine connects to the opioid receptors, it deters other opioids from connecting, rendering them inefficient. In simple words, when buprenorphine is there, other opioids would not work. On the other hand, Naloxone is an opioid antagonist. And is the active component in Narcan, the drug used to overturn an opioid overdose.

Suboxone is rare in that the only moment the Naloxone gets activated is if the person ingests Suboxone clinics that take Medicaid in a manner that is not specified, like an injection. The Naloxone in the Suboxone is a hindrance, so people are less inclined to abuse Suboxone. Suboxone, when taken as approved, lessens cravings and uncomfortable opioid withdrawal symptoms. Suboxone also halts the consequences of other opioids if a relapse arises.

How Is Suboxone Used In The Treatment Of OUD?

More than 2 million people in the US were dependent on opioids in 2018. Of those 2 million, just over 75% were addicted to painkillers, while the rest strived with heroin addiction. Suboxone is a MAT (Medication-Assisted Treatment) during three stages of treatment for an opioid use disorder.

When a person arrives for treatment for opioid addiction, they generally need a medically supervised detox. After 12-24 hours, an individual can start a Suboxone treatment program. Beginning before that would cause severe withdrawal symptoms to occur. Once an individual has adapted to Suboxone and no other opioids exist, the person is stabilized. The medical experts may adjust frequency and dosage depending on individual desires.

The last stage is what is deemed a maintenance stage. The objective of this is to retain sobriety and deter a relapse. Doctors will talk about how long a person needs to proceed with this maintenance dosage, and this time frame differs from person to person.

Why Is Suboxone The Preferred MAT?

Suboxone has fewer constraints than other MAT drugs, like methadone. Suboxone can be specified outside of a hospital setting. People are also less inclined to abuse Suboxone because it is not as powerful as other opioids, it doesn’t work if it is inoculated, and the naltrexone activates when injected, occurring in sudden withdrawal indications.

Dangers associated with Suboxone are lower as well. Suboxone is 4 times less inclined to result in an overdose than methadone. Moreover, any reported overdose comprising Suboxone occurred when an individual blended Suboxone with CNS depressants like alcohol or benzos. Online suboxone doctors that accept Medicaid seem to be safer for women who are pregnant. Buprenorphine study has shown positive effects when used in addiction treatment. People are less likely to quit rehabilitation, overdose, or relapse.

Potential Costs With Medicaid

A person’s extra costs when using Medicaid to cover their cost of treatment vary by state. Some states cover Suboxone entirely, while others may require that the people pay a copay or a small expenditure of somewhere between $10-30 each month. Also, some states’ Medicaid may only cover the tablet form of Suboxone but will not cover more costly formulations like the injection or the implant. If a patient needs a different formulation, they may require to pay for the drug out of pocket. 

How to Register for Medicaid? is a vital information hub for starting the Medicaid registration procedure. There are nearly two ways for an individual to apply for Medicaid. Firstly, and for numerous people, the easiest way is through the Health Insurance Marketplace, a government resource formulated to help people discover the ideal insurance plan for their requirements. By generating an account on the marketplace and giving the requested data, you can see whether Medicaid is accessible and what medication for addiction treatment would cover it. You may also learn other insurance plans in your price span that give similar or better coverage, depending on your needs. Then, if you authorize Medicaid, your data will be sent to the related Medicaid agency, and they will reach you.

The second technique is to apply to your state’s Medicaid agency immediately. The link delivered above includes the information you require to get in contact with the relevant mechanism. If you need help starting up, talk to your physician. Most health centers have insurance consultants that can help walk patients through the procedure of registering for insurance, including Medicaid. 


Once Medicaid covers you, you’ll be required to find a doctor to prescribe Suboxone. Several primary care doctors prescribe Suboxone, and addiction specialists and consultants. If you have suboxone doctors near you that take medicaid, inquire if they or any of their collaborators prescribe Suboxone.

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