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Unread 08-29-2015, 05:12 PM   #1
ajk
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Default Does Kaiser provide or cover Methadone Maintenance

My husband has been on Methadone for over six years. We have been paying out of pocket every month the entire 6 years through a Methadone Clinic that refuses to accept any form of insurance but Medicaid. This is costing us thousands of dollars a year, more than a monthly car payment. My husband also has really good health insurance through Kaiser, which also costs thousands of dollars a year. This financial burden is a HUGE strain on our family and relationship. Not to mention all the other strains Methadone puts on a relationship.
I'm not a 100% sure why, but my husband refuses to ask his primary care doctor at Kaiser about Methadone Treatment. It may be part of his very low drive to do anything, which is a significant side effect of his Methadone Therapy. Or, he may be worried about judgment from his doctor. Whatever it is, he flat out refuses to discus any Methadone related subject with me.
My questions:
Is there anyone out there who has received treatment with Kaiser?
Do all Methadone Clinics refuse Private Insurance? (He had a Blue Cross PPO before Kaiser that they refused to take also)
Someone please help. I'm at the end of my rope and at tears as I type. My children are getting older and more expensive. It's getting harder and harder to budget, and we are going with out so much already...
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Unread 09-01-2015, 11:32 AM   #2
Eliza12
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Hi ajk,

Kaiser has an addiction medicine department, but I'm not personally familiar. I believe they are offering suboxone treatment now, but not sure about methadone. Switching to suboxone might be an option for your husband. Without his cooperation or even willingness to have a conversation, not sure what you can do. Does he plan to stay on methadone indefinitely? Has he worked on his recovery by going to counseling and/or participating in a group like NA/AA? Ideally, the medication would be eventually tapered down and stopped.

Hope you can get him to talk with you about it and find a solution that doesn't cost so much. You can also call Kaiser yourself to get the info without revealing any of his information, but again, he would need to agree to make a change.

Hope this helps.

Best,
Elizabeth
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Unread 09-01-2015, 04:46 PM   #3
NancyB
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Hi ajk, to add to what Elizabeth said, it is illegal for doctors to prescribe methadone for addiction treatment. It has to be from a methadone clinic. Doctors can prescribe methadone for pain though.

Does he get receipts from the clinic? Have you tried submitting them to Kaiser for self reimbursement? Have you gone on the Kaiser site to see if they have coverage - or give them a call to find out. I tried looking at the Kaiser site, but there are too many specific items wanted and I couldn't do a general search.

Nancy
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Unread 09-28-2015, 07:48 PM   #4
Sara G
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Hi Nancy,
I read your post because I researching Kaiser and Suboxone coverage. Kaiser does have a behavioral health department but... my previous experience with Kaiser involved lengthy appointments to prove you are clean. They required almost daily appointments and drug tests until they establish you (or your husband in this case) are clean and serious about your recovery. I know that the methadone clinic is cash only and charges you by the day. It is extremely expensive for the convenience of it.
My recommendation is to call Kaiser and pose as a potential patient.
Remember: The hassle of dealing with preventative insurance and reimbursement is nothing compared with the expense of active addiction.
Buprenorphine/Naloxone such as Suboxone and Zubsolv is cheaper because of the prescription cards that cover up to $200 of the prescription in some cases. Kaiser covers the doctor's appointments. Food for thought.
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Unread 09-28-2015, 08:55 PM   #5
NancyB
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Quote:
Originally Posted by Sara G View Post
Hi Nancy,
I read your post because I researching Kaiser and Suboxone coverage. Kaiser does have a behavioral health department but... my previous experience with Kaiser involved lengthy appointments to prove you are clean. They required almost daily appointments and drug tests until they establish you (or your husband in this case) are clean and serious about your recovery. I know that the methadone clinic is cash only and charges you by the day. It is extremely expensive for the convenience of it.
My recommendation is to call Kaiser and pose as a potential patient.
Remember: The hassle of dealing with preventative insurance and reimbursement is nothing compared with the expense of active addiction.
Buprenorphine/Naloxone such as Suboxone and Zubsolv is cheaper because of the prescription cards that cover up to $200 of the prescription in some cases. Kaiser covers the doctor's appointments. Food for thought.
Thank you so much for that information Sara G! It's very much appreciated.

Welcome to Addiction Survivors too.

Nancy
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Important disclaimer: Any information in this post is not and does not constitute medical advice under any circumstances. Addiction Survivors, Inc. does not warranty or guarantee the accurateness, completeness, adequacy or currency of the information contained in or linked to the Site. Your use of information on the Site or materials linked to the Site is entirely at your own risk. NEVER take any online advice over that of a qualified healthcare provider. Any information contained on AddictionSurvivors.org should only serve to inspire further investigation with credible, verifiable references sources such as your physician or therapist.
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Unread 10-28-2015, 10:39 AM   #6
MattC42286
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Hi ajk! Talk to him about suboxone and have him read the success stories. Quality of life will improve like never before!! Good luck and God bless!!!
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