Addiction Survivors

Reply
Unread 06-14-2010, 06:22 AM   #1
NancyB
Administrator
 
Posts: 22,568
Default What insurance do you have, what does it cover?

Hi, Lonney mentioned in a post in the "(Yet another) generic story....." thread that it would be nice to have a list of what insurance companies cover what. Since it would be near impossible to do because of the variation in coverages - even within one insurer, maybe we could use this thread and people could say what insurance company they have, what type of plan, what it covers, co-pays, etc. If you'd like to put what state you're in, that would be great, but we totally understand if you'd rather leave that out because of anonymity purposes.

Please keep this thread for that information only; we can use this older thread for any commentary:
http://www.addictionsurvivors.org/vb...ad.php?t=22039

Thanks for you help!

Nancy
__________________
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.
NancyB is offline   Reply With Quote
Unread 06-18-2010, 06:14 AM   #2
NancyB
Administrator
 
Posts: 22,568
Default

bump
__________________
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.
NancyB is offline   Reply With Quote
Unread 06-18-2010, 08:22 AM   #3
Julnjer
Senior Member
 
Julnjer's Avatar
 
Posts: 451
Default

My Inusrance carrier is "United Healhcare".My co-pay at the doctor visit is 15.00. My prescription benefits are caled "CVS CAREMAKE". I can use almost any pharmacy and I received 60 pills for a month with a 44.00 copay....hope this helps.
Julnjer is offline   Reply With Quote
One User Says Thank You to Julnjer For This Useful Post:
Thank You (06-18-2010)
Unread 06-18-2010, 12:24 PM   #4
So.Cal.
Senior Member
 
So.Cal.'s Avatar
 
Posts: 3,410
Default

i like your brainstormin!!!!lol
TT
So.Cal. is offline   Reply With Quote
Unread 06-18-2010, 01:59 PM   #5
Sam Bailey
Senior Member
 
Posts: 856
Default

Hey Nancy,

Even though I'm no longer using Sub, my insurance plan is the same...and the benefits are also the same, even so far as the current Sub program. I know this due to an old bill (like, years old!) that hadn't been properly paid, which i found in my mail box a couple of months ago. Long, boring story, tho it required me to put a call into my insurance folks...and I asked several questions.

Anyway, for what it's worth: My insurer was (is) Blue Cross, Anthem. My co-pay for every doctor's visit was $10 bucks, and I visited him once every two months.

My co-pay for the medication (whether 8mg or 2mg) was the same: $7.50 per prescription, no matter the number of tablets. If there'd been a generic tablet (back then there was not), the cost would have been $5.00 per prescription.

My wife's a school teacher, and it's through her insurance. And it's really great. I mentioned my double knee operation on July 1,2009 (almost exactly a year ago), the medical costs were, I think, something like $4,000 dollars (per knee? maybe it was for both? hmmm?? ) In any case, MY cost was...$10.00 for the entire dealeo. Total.

Not boasting, just saying...there are some great insurance deals out there. However, fyi, our dental insurance is, like, beyond awful. So, in all things, there's a balance. Well, sometimes; and sometimes our health care, all-around, is just completely and totally unfair.

Go Obama Care! (Sorry OMike. Ha!)

best,

sam b
Sam Bailey is offline   Reply With Quote
2 Users Say Thank You to Sam Bailey For This Useful Post:
Thank You (06-18-2010), Thank You (06-18-2010)
Unread 06-18-2010, 02:19 PM   #6
OhioMike
Senior Member
 
Posts: 11,418
Default

Nancy, I had Anthem, blue cross / blue shield.

They had no problem paying for my expenses, however, the first opportunity they got, they dropped me.

Being a small business person, I was self insured and not protected by the terms of a group plan. In hind sight, I would have joined a group plan and suffered the limited healthcare thereof.

As Obama wishes us to do! (Sorry Sam! lol)

Mike
__________________
As you think, so shall it be!
OhioMike is offline   Reply With Quote
One User Says Thank You to OhioMike For This Useful Post:
Thank You (06-18-2010)
Unread 06-18-2010, 04:19 PM   #7
vhappy
Senior Member
 
Posts: 2,123
Default

I have blue cross of alaska, they provide up to 15,000 a year in addiction/rehabilitation services for me and my husband. However my doctor does not accept it and I have to pay 150.00 per phone visit 1x per month. I could turn in the paperwork and be reimbursed I was told, but am a little afraid that if I do, something could jepordize my treatment. So far that would be 2,850.00 (that would sure be nice to add to my Hawaii account). I also pay 30.00 co-pay for 45-suboxone per month. Is it possible to to file a claim after treatment is complete?

vhappy
vhappy is offline   Reply With Quote
One User Says Thank You to vhappy For This Useful Post:
Thank You (06-18-2010)
Unread 06-18-2010, 04:43 PM   #8
beekeeper
Member
 
Posts: 33
Default

I had Cigna, Rx was written for Chronic Pain, $30 co-pay for 120 8mg. Did not need refill.
beekeeper is offline   Reply With Quote
One User Says Thank You to beekeeper For This Useful Post:
Thank You (06-18-2010)
Unread 06-18-2010, 05:50 PM   #9
packrat
Senior Member
 
packrat's Avatar
 
Posts: 610
Default

Oxford
dr $30
mess $50 copay
p/a 1 year at a time
__________________
We are all living proof that there is life after addiction.
packrat is offline   Reply With Quote
One User Says Thank You to packrat For This Useful Post:
Thank You (06-18-2010)
Unread 06-21-2010, 09:26 AM   #10
okie
Senior Member
 
okie's Avatar
 
Posts: 1,913
Default

Tricare here..retiree/prime..visits are $25 with the shrink..and FINALLY Tricare is covering suboxone and subutex...$3 co pay for the generic and $9 for name brand..monthly, regardless of the prescribed quantity.
__________________
If you are going through hell... keep going.
okie is offline   Reply With Quote
Unread 07-01-2010, 12:22 PM   #11
DARKEYES
Senior Member
 
DARKEYES's Avatar
 
Posts: 1,070
Default

Quote:
Go Obama Care! (Sorry OMike. Ha!)
Sorry, I KNOW people who have the health care ostupid wants to pass and they wait months for mris, cat scans, DOCTOR APPOINTMENTS. NO WAY.....I don't get into politcs, but I just don't like that man.


Anyhow, I have UPMC FOR LIFE health care, I was going to go with United until I saw the co pays. Usually there is no co pay for doctor visitors specialists, nor referrals. I pay $3.30 for a month supply of Suboxene, however since my doctor no longer participates with the insurance company I pay him until a doctor that does calls me, I think I'm on every list in the STATE, and this city of course. Good idea Nancy, thanks.
__________________
DARKEYES.
DARKEYES is offline   Reply With Quote
Unread 07-01-2010, 02:16 PM   #12
Jamesisdone
Senior Member
 
Posts: 992
Default

I had medicaid and it covered my doctor's appointments and my perscription was $1.
Jamesisdone is offline   Reply With Quote
Unread 07-01-2010, 02:22 PM   #13
LKB1956
Senior Member
 
LKB1956's Avatar
 
Posts: 282
Default

I have Cigna and pay a 25 dollar co-pay for the Dr. My prescription of 60 pills a month is capped at $50. Pennsylvania
__________________
One day at a time, Linda
LKB1956 is offline   Reply With Quote
Unread 07-01-2010, 02:45 PM   #14
OpioidsGotMe
Senior Member
 
OpioidsGotMe's Avatar
 
Posts: 248
Default

I have insurance through "Kidscare" witch is medicaid. I just wanted to say, and I'm not sure how many states have something like kidcare, but in Illinois all kids under 19 years of age without insurance qualify and their guardians (me) that qualify (no insurance and meet the income requirements) get medicaid. With that said it did cover my Dr. visits when he took medicaid, I just needed a referal by my primary, but my sub Doctor stop accepting medicaid for all patients 2 years ago. But my suboxone is still covered just with a $3.00 copay.
James what state are you from. I ask because that is a nice low copay $1.00.

Darrin
OpioidsGotMe is offline   Reply With Quote
Unread 07-01-2010, 03:26 PM   #15
Jamesisdone
Senior Member
 
Posts: 992
Default

I'm in Kentucky and yes the copay was extremely awesome. I did get to see the doctor for free although it was required to see HIS drug counselor who refused to take my insurance even though she worked in his office and that was 65.00 a week but heck I still couldn't complain. The only problem I've found is that here in KY he is the only Sub doc who took my insurance so I stuck with him... Darrin did you find that to be a problem?
Jamesisdone is offline   Reply With Quote
Unread 07-01-2010, 05:35 PM   #16
OpioidsGotMe
Senior Member
 
OpioidsGotMe's Avatar
 
Posts: 248
Default

Hi james, well when I first started suboxone I didn't have insurance so at the time this doctor was only $150 for the initial visit and $55 every monthly visit there after. So being that other suboxone doctors were closer to the $1000 or more in some cases for the first visit, I chose this doctor. Then I got medicaid and he took that for about 1 year then I guess there are problems for some doctors to take medicaid so now I pay out of pocket for dr. visits, witch are now $70 a visit, not to bad going up $15 in 3 years. But medicaid still covers my suboxone. The problem is my son turns 19 a year from this august and that will end my medicaid. I'm going to try and get medicaid for me and my son after that, since we both have issues that keep us from working full time. If I don't get the medicaid continued after that I'm hoping by then generic is cheep enough that I can afford it on my own. But back to your original question, since I got off track, I guess I got lucky at the time I found this doctor even though there still are not a wide choice of suboxone doctors that are affordable.
As for you having to pay for the counselor I guess like you said you can't complain if thats all you have to pay out of pocket for. Good luck with everything.

Darrin
OpioidsGotMe is offline   Reply With Quote
Unread 07-02-2010, 03:58 PM   #17
because maybe
Junior Member
 
Posts: 1
Default

I'm in New York... my insurance is MVP. the doctor's visit cost me nothing and the script, no matter how many pills it is, is 3 dollars. but i've recently had to change doctors and the one i'm at now doesnt take any kind of insurance so it's $150 for the visits, which are, so far, every 2 weeks.... it's a bit of a pain after being used to not paying anything for so long..
because maybe is offline   Reply With Quote
Unread 07-26-2010, 08:33 PM   #18
k3pain
Member
 
Posts: 38
Default

I have a AETNA PPO plan which pays $35 for visits, every 6 months required now, and paid $100 the max/for name brand so I paid 1$ per pill,now that i have earned my doctors trust she wrote me a generic Subutex 3 month prescription through CVS/Caremark. CVS could not fill the order they said it was on back-order, so they sent it to their parent company Caremark and they just fill 3 months/300 subutex 8 mgs. for $20. Thats awesome,from $300 every three months to $20 plus a doctors visit every 3-6 months
k3pain is offline   Reply With Quote
Unread 07-29-2010, 08:35 AM   #19
DARKEYES
Senior Member
 
DARKEYES's Avatar
 
Posts: 1,070
Exclamation Good news for those that have upmc

Speaking with my concierge yesterday, I was told that now PCP's are able to write prescriptions for a ninety day supply of medication and still the co-pay would be the same as for one month. So if you get blood pressure meds for a month at a time, for example, your doc can give you a three month supply and the co-pay will be the same 1.10 for generic and 3.30 for non-generic medications. Since Suboxene is a controlled substance, I'm not really sure about that one, but IMO it would not be covered because it is a must with UPMC that counseling is involved with the treatment, as well it should be.
__________________
DARKEYES.
DARKEYES is offline   Reply With Quote
Unread 07-30-2010, 09:13 AM   #20
k3pain
Member
 
Posts: 38
Default

i just got my first 90 day script 4 generic subutex, 300 8mgs 4 $20 AND I get one more refill. So DARK EYES you r correct on your first statement but the second is not true, insurance company's do not care about us. I will continue to seek counseling BECAUSE 600 pills is scary,on the other hand I can only get 5mg Generic Ritalin 4 30 days and then I have to stop by the doctors office for another script, no charge. My other physc doc charged me for every visit to pick up A 30 day script, but I bet my insurance will want to save money and write a letter to the doctor asking for 90 day scripts, which i can get at CVS or Caremark mail. CVS pharmacy could not get the 300 generic subutex. I hate to tell you how many times in the past I would get 90 scrpts for norco, morphine, oxy , and xanax, thats how i got so messed up to start. Mail orders r discrete, not even your wife know you have a pharmacy of huge factory packaged bottles hidden all over the room. But the bad part is: 1) what if my kids gound a bottle of 360 AVINZA, or HYDROCODONE, they may figure they need 4-6 to gt them high,(that never happened but I was always nervouse and: 2) tempation, if you use all of it at the begining then the last 2-4 weeks are hell, but I figured out a way around that too. But anyways first day on generic sub and they taste like putting a generic white tylenol in ur mouth and wait 4 it to dissolve, it doesnt have any orange taste, GOD I miss that, and it doesnt melt. But its the insurance co. that have some accountability, they force you to get 90 day supplys or they will not refill your 30 script at any pharmacy,
k3pain is offline   Reply With Quote
Unread 07-30-2010, 01:12 PM   #21
DARKEYES
Senior Member
 
DARKEYES's Avatar
 
Posts: 1,070
Default

Quote:
Originally Posted by k3pain View Post
i just got my first 90 day script 4 generic subutex, 300 8mgs 4 $20 AND I get one more refill. So DARK EYES you r correct on your first statement but the second is not true, insurance company's do not care about us. I will continue to seek counseling BECAUSE 600 pills is scary,on the other hand I can only get 5mg Generic Ritalin 4 30 days and then I have to stop by the doctors office for another script, no charge. My other physc doc charged me for every visit to pick up A 30 day script, but I bet my insurance will want to save money and write a letter to the doctor asking for 90 day scripts, which i can get at CVS or Caremark mail. CVS pharmacy could not get the 300 generic subutex. I hate to tell you how many times in the past I would get 90 scrpts for norco, morphine, oxy , and xanax, thats how i got so messed up to start. Mail orders r discrete, not even your wife know you have a pharmacy of huge factory packaged bottles hidden all over the room. But the bad part is: 1) what if my kids gound a bottle of 360 AVINZA, or HYDROCODONE, they may figure they need 4-6 to gt them high,(that never happened but I was always nervouse and: 2) tempation, if you use all of it at the begining then the last 2-4 weeks are hell, but I figured out a way around that too. But anyways first day on generic sub and they taste like putting a generic white tylenol in ur mouth and wait 4 it to dissolve, it doesnt have any orange taste, GOD I miss that, and it doesnt melt. But its the insurance co. that have some accountability, they force you to get 90 day supplys or they will not refill your 30 script at any pharmacy,
Just lost my whole post so here we go again. I was posting about MY INSURANCE and what they allow. Continuing with therapy is a very good choice. I don't know what insurance you have, but mine does not allow a 90 day supply of Suboxene. It does however allow a month supply but you must have the doctor or your therapist send in confirmation that you are indeed into counseling with sub. Sorry if I confused you, but I did speak to the concierge for quite some time and in order to continue with treatment with sub, only one month supply is allowed and that's cutting it thin, they like it more if you go every two weeks at first. It matters not to me if I go once a month or every two weeks because the most important thing is to keep this disease into remission. Insurance companies have us by the ass, car, life, home, you name it and the HMO'S are probably the worst you either follow the formulary and benefit booklet or change insurance, it all depends on the HMO that you have.
__________________
DARKEYES.
DARKEYES is offline   Reply With Quote
Unread 07-30-2010, 11:45 PM   #22
k3pain
Member
 
Posts: 38
Default

I was posting about " MY INSURANCE and what they allow." Sorry I lost your post, but the origional post was started by Nancy. I will try not to ramble on again, but I was nervous about my new script and the amount, I will try not to mess up next time, but thats why I stopped posting for the last few months any way. I just started on this thread.
k3pain is offline   Reply With Quote
Unread 08-01-2010, 07:09 PM   #23
jdjk
Senior Member
 
Posts: 433
Default

Nancy,

It might be appropriate if the poster also listed the state in which they live.
jdjk is offline   Reply With Quote
Unread 08-01-2010, 07:26 PM   #24
NancyB
Administrator
 
Posts: 22,568
Default

Hi jdjk, yes, good idea, thank you. So if people can also add in their state, that would be good.

Thanks for participating.

Nancy
__________________
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.
NancyB is offline   Reply With Quote
Unread 08-01-2010, 09:43 PM   #25
Surrendered07212010
Member
 
Surrendered07212010's Avatar
 
Posts: 99
Default

I have kaiser of ga. Out of pocket for doctor . I have hmo kaiser,so then office visit is not. Reimbursable. The suboxone is a covered drug. . 30 bucks for 30 day supply. Kaiser does have a suboxone clinic, but the wait was several months. I will investigate this week what type of coverage is there for the counseling. Will let you all know.
Surrendered07212010 is offline   Reply With Quote
Unread 10-15-2010, 11:26 AM   #26
sws1967
Member
 
Posts: 32
Default

I live in Los Angeles, work for a large university and have Anthem blue cross HMO group insurance.

My prescription is 90 8mg pills per month.

Subutex (generic or brand-name): My insurance will only cover 11 out of the 90 pills, and this is only per 90 days. For the 11 pills per 3 month period, I still have to pay a $15 co-pay for the generic. My total cost at Rite Aid for Subutex generic, using my insurance is: $800.

Suboxone: My insurance treats this like any other brand-name medication and I pay $30 co-pay for whatever amount the doctor writes (90 8mg/2mg) at this time.

It's a bummer, because I really wanted Subutex but, with that difference in price, I obiviously chose the Suboxone. (I could have gotten Subutex generic cash at about $3 each at only one pharm, most were $7+ cash price in this area).

-sws
sws1967 is offline   Reply With Quote
Unread 10-15-2010, 11:54 AM   #27
mlk_2900
Member
 
mlk_2900's Avatar
 
Posts: 73
Default

I have Blue Cross Blue Shield of NC. My doctor however does not accept my insurance so I pay out of pocket for that, $85.00 each visit (currently weekly still). Otherwise though I believe my insurance would cover my visits with a $30.00 copay.

I have a $10.00 copay for my medicine, generic subutex of whatever quantity, each time I get it filled. If I was taking brand name Suboxone it would be a $25.00 co-pay each time.
mlk_2900 is offline   Reply With Quote
Unread 10-15-2010, 12:06 PM   #28
gotitang
Senior Member
 
gotitang's Avatar
 
Posts: 1,521
Default

I live in Northern California and I have Kaiser. They have a program called CDRP and it covers a year long out patient program for whatever your co-pay is. Mine was $5.00 a day. So in the beginning it seemed pricey cause you have to go everyday. But the longer your in the program the less time your going. By the 6 month mark your only going once a week. Meds are covered by whatever your plan covers. Some pay $30.00 for prescriptions and others pay $5.00.
I'm not sure if they are using the generic sub yet. Or the strips.
gotitang is offline   Reply With Quote
Unread 10-19-2010, 12:52 AM   #29
SLIP67
Member
 
Posts: 55
Default

I live in FL and currently have Blue Cross/Blue Shield for medical coverage. I'm not sure I have all the information that you're requesting, but here's what I have:
Just started this program for opiate withdrawal 3 weeks ago. When I was making 1st appointment, I was told that this was for 10 weeks and included blood work, weekly therapy and doctors visits. The cost was $3,500. They asked that I put something down the 1st time in, so I gave them $100. Since then I have paid $20 twice, which is the co-pay. I haven't gotten a full month Rx for the Sub yet. The last time I was there, the doctor wrote Rx for 42 of the 8 mg Suboxone. I can get it filled wherever I want. "Medco" covers my prescriptions. I paid $65 for 42 pills, which after reading everyone else's posts, isn't all that great!
SLIP67 is offline   Reply With Quote
Unread 10-22-2010, 09:39 AM   #30
deanna
Senior Member
 
deanna's Avatar
 
Posts: 2,957
Default

I live in Ohio, I have Frontpath insurance, and my co-pay is $10. thanks to the coupon for the film strips though, the scripts will be free til March of 2011
__________________
"Its you vs. you"
deanna is offline   Reply With Quote
Unread 10-22-2010, 07:50 PM   #31
SLIP67
Member
 
Posts: 55
Default

Quote:
Originally Posted by deanna View Post
I live in Ohio, I have Frontpath insurance, and my co-pay is $10. thanks to the coupon for the film strips though, the scripts will be free til March of 2011
Wow! Can you tell me where you found coupons for the film strips?
SLIP67 is offline   Reply With Quote
Unread 10-22-2010, 07:52 PM   #32
nan
Senior Member
 
nan's Avatar
 
Posts: 2,129
Default

hi slip67, You will find the coupon on this link,

http://www.addictionsurvivors.org/vb...ad.php?t=25069

nan
nan is online now   Reply With Quote
One User Says Thank You to nan For This Useful Post:
Thank You (10-23-2010)
Unread 10-23-2010, 08:44 AM   #33
deanna
Senior Member
 
deanna's Avatar
 
Posts: 2,957
Default

Quote:
Originally Posted by SLIP67 View Post
Wow! Can you tell me where you found coupons for the film strips?
Thanks Nan for helping out!!! Yea, SLIP67, just print that coupon out and each month you go to fill the prescription you just bring it with you and its FREE!!! And I have written about the film strips, I like them much better than the pill form and they are very easy to cut down when tapering.
__________________
"Its you vs. you"
deanna is offline   Reply With Quote
Unread 10-25-2010, 06:55 PM   #34
MaJaBe
Senior Member
 
MaJaBe's Avatar
 
Posts: 1,206
Default

Citruscaid, not a darn thing.
MaJaBe is offline   Reply With Quote
Reply

Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off




All times are GMT -4. The time now is 09:46 AM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
© 2014 Addiction Survivors