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Unread 01-27-2013, 09:19 PM   #1
Xtrasmall73
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Posts: 13
Question Michigan Medicaid hmo's


Something happened to My bff this week & I'm curious if this is what I should expect because this is My 2nd week on Suboxone & I'm wondering if I should prepare to ween as quickly as possible so I'm not caught off guard like She was:
My bff was put on Suboxone by Her pain management Doctor, Who happens to also be the head of anestesiology (sp?) @ a local S.E Michigan hospital.He had her on 8mg 3x a day.In order for Medicaid to pay for Suboxone,Drug abuse counseling is mandated even for people like Me who are physically dependant not addicted.We're all catagorized together.She is an opiate abuser & We both are chronic pain patients.Her Doctor knew She's an addict,So he was also using it for pain management. Last week,She went to the pharmacy to fill her 90 strips (1 month supply) & they told Her that Her prior authorization was only valid for one year & she needed another one so it would be a few days.The pharmacist let her pay cash for 7 strips while the doctors office staff handled getting a new prior auth.A few days later,same thing.He sold her 6 @ her expense while the doctors office continued to try to get the authorization.The pharmacy kept telling her as soon as it was approved,She'd be reimurssed as long as she kept her reciepts.Now,over a week later, She gets told she had it for 1yr & they will not pay for any more strips or drug abuse counselling.Just BAM! No warning, No titraiting down,No weening.She's now in full fledged Sub withdrawl & no one will help.I cant give her any of mine because I only get a 1 week suply until I'm going 3-6mos.I also have to bring all opened foils & unopened foils to be counted & lot #'s checked (which is kinda bullshit when I'm not an addict,I'm just pd yet She'd get 90 @ a time & she's the addict!) Has this happened to any other Michiganders with Medicaid? I have Molina of Michiganbut just switched to Meridian Health.Its effective as of Feb 1st.She has Meridian.Is 1yr limit Michigan Medicaid's new policy for all hmo's or is this Meridian's rules? I'm very frusterated on what to anticipate & she's already talking about getting back on pain pills/dope because She needs something for pain.I see it as 1 entire year of sobriety wasted if she's just going to return to old habits & former behaviors.I could see if they started to ween her down months ago but very irresponsible of her insurance & doctor to cut her off @ such a high daily dose, Knowing Suboxone withdrawl is just as bad, if not worse then hydro withdrawl. I don't even think She's able to get opiates @ a pharmacy now that She's been on Sub..I was told all of Us on Suboxone/Subutex were "red-lined" or "flagged" & it doesn't matter what Sub was perscribed for (addiction or physical dependance/opiate tolerance).Anyone know if there's any truth to that?
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Unread 01-27-2013, 09:26 PM   #2
Xtrasmall73
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btw,It's showing this thread on both this forum & the insurance questions forum & I'm not sure why.But seeing I'm not sure which forum it goes in,Maybe 2x the chance of someone knowing the answer.Just wanted to appologise if it upset anyone or ticked off a Moderator.My Bad!
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Unread 10-15-2014, 08:27 PM   #3
Lynners22
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How are things going? I too have had a hell of a problem with Michigan medicaid...i have united as of right now but only until i decide which insurance is better for the sub treatment...Molina? Meridian? Ive been seeing same dr for just over a year and now hes not "accepting" ANY medicaid plans...I have the prior authrization all set. But need a dr that accepts one of the MI medicaid plans because I cannot afford the $130 office visit every 2 weeks!!! Please tell me you know a dr that i can get into asap somewhere in southeast mi?!?!? I live near chesterfield but am surely willing to travel...Any help is much appreciated. THANK YOU
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