Will Insurance Cover Suboxone Detox In Florida?


Suboxone detox is covered under most insurance plans in Florida because of the Affordable Care Act. However, coverage varies depending on the insurance carrier. If someone requires medical care, insurance is usually the last thing someone wants to think about, and getting help is the most important part.

Suboxone can help people recover from opioid use disorder, and most people use this medication for this purpose. However, it is essential to take Suboxone exactly as a doctor recommends to avoid developing a substance use disorder, or addiction, to the drug. However, this is rare.

 Does Health Insurance Cover Suboxone Detox?

When it comes to using insurance for Suboxone detox, most insurances cover the process under medication-assisted treatment, or MAT. This treatment option is the standard for treating substance use disorders.

Insurance coverage for Suboxone detox will vary in cost when it comes to co-pays, deductibles, and out-of-pocket costs. Some insurance companies that do cover Suboxone detox include, but are not limited to: 

  •     Aetna
  •     Anthem
  •     Blue Cross Blue Shield
  •     Humana
  •     Kaiser
  •     Medicaid
  •     TRICARE
  •     UnitedHealth Group

Patients can find financial assistance for drug rehab in government-sponsored programs, such as Medicare, Medicaid, and HealthCare.gov marketplace plans. If you meet certain income requirements or other criteria, you may qualify for free or low-cost health insurance plans that cover treatment for substance use disorders.

Does My Plan Need to be In-Network?

Most referral programs or even the insurance companies themselves will attempt to place a patient somewhere within their network of care. Out-of-network simply means that the facility does not have an existing agreement with the insurance provider to provide discounted treatment.

However, there are processes to appeal, or there are authorization protocols that insurance companies can make with out-of-network facilities to allow patients to access care on a referral basis. Luckily, due to the Affordable Care Act (ACA), private insurance companies must provide some form of substance abuse treatment coverage to their customers.

Does Medicaid Cover Suboxone Detox?

The Affordable Care Act (ACA) requires that all marketplace healthcare plans must cover substance abuse and mental health services like other essential health benefits. The ACA also states that mental health and substance abuse are like other pre-existing conditions. Therefore, they are no longer grounds for insurance to deny coverage.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), all states reimburse for some form of prescription medication for MAT, and even more specifically, for some form of Suboxone and its components, buprenorphine, and naloxone.

Another important note from SAMHSA is that several states require documentation that a patient is being referred or concurrently receiving some form of authorized therapy or psychiatry along with the medications. This will allow Medicaid to provide some sort of coverage for Suboxone treatment.

How Much Does Suboxone Cost Without Insurance?

Suboxone prescriptions range between $90 to $600 for a 30-day supply without insurance. The cost is affected by strength, the number of doses, and the form of the Suboxone taken.

Suboxone strips could cost between $60 to $250 for 14-day supplies. The lower strength doses (2 mg/0.5mg or 4 mg/1 mg) cost less, with higher strength doses (8 mg/2 mg or 16 mg/4 mg) costing between $10 and $20 per strip. Most patients do not exceed 16 mg/4 mg dosages, but 24 mg/4 mg doses exist.

In general, Suboxone tablets are cheaper than strips. The 2 mg/0.5 mg tablets cost $3 to $4 per tablet, and the 8 mg/2 mg tablets cost $6 to $8 per tablet.

The target dose of Suboxone for most patients is somewhere between 12 to 16 mg/4 mg.

Signs and Symptoms of a Suboxone Addiction

 There is a mix of physical, behavioral, and psychological symptoms of Suboxone addiction.

 Physical symptoms include: 

  •     Gastrointestinal disturbances such as appetite loss, nausea, vomiting, and diarrhea
  •     Dilated pupils and tearing
  •     Impaired or slurred speech, and fainting
  •     Fevers, sweating, and muscle aches
  •     Sleep disturbances and drowsiness
  •     Increased blood pressure
  •     Hair loss

 Behavioral symptoms include: 

  •     Receiving multiple prescriptions of Suboxone in excess
  •     Presence of paraphernalia such as needles or ropes for constriction
  •     Disinterest in hobbies
  •     Unexplained weight loss
  •     Unexplained financial hardship

 Lastly, psychological symptoms include: 

  •     Poor coordination, motor skills
  •     Emotional dysregulation
  •     Forgetfulness and lapses in memory
  •     Apathetic mood and disinterest in hobbies
  •     Depression
  •     Erratic behavior

Researchers intended to use suboxone as a replacement drug for those with opioid addictions to receive treatment. However, albeit rare, Suboxone can cause addiction to itself and therefore be abused.

 Get Your Questions Answered

Call Agape Detox. With various treatment options, including medically supported detox services, inpatient rehab, dual diagnosis treatment for co-occurring disorders, and numerous therapy options, their goal is to provide safe and comfortable detoxes to each client.

 Located in Port St. Lucie, Florida, Agape Detox provides a resort-like setting with skilled and caring professionals, focusing on a holistic approach to help people achieve total wellness and reclaim their lives. Get your questions answered and get help by calling (855)-948-2936 today.

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