Methadone maintenance treatment (MMT) programs, also referred to as opioid agonist treatment, are known for their cost-effectiveness in treating opioid addictions.
A methadone maintenance treatment program’s cost can change depending on several factors, including:
- duration of treatment
- treatment type
- health insurance coverage
However, the National Institute on Drug Abuse estimates that an outpatient methadone treatment program’s total cost is $126 per week or $6,552 a year (assuming daily visits).
Will Health Insurance Cover A Methadone Maintenance Treatment Program?
Although the Affordable Care Act requires all insurances to cover addiction treatment the same way they would other health care, not all insurance plans cover all forms of addiction treatment.
Getting coverage for a methadone maintenance treatment program will depend on geographical location and the insurance plan’s specific health services.
Reasons Your Insurance May Deny MMT
Some insurances may place restrictions on the number of prescriptions filled each year, making it tricky to account for a methadone maintenance program.
Commercial health care plans are more likely to offer some treatment coverage as long as someone can meet the following criteria:
- demonstrate a medical need to enroll in an MMT program
- has paid the required amount for their co-pay
Getting Methadone Maintenance Covered By Your Health Insurance
The best way to determine if health insurance will cover a methadone maintenance program’s cost is to call the number on the back of the card and speak to an agent directly.
It is also important to note that health care costs will vary depending on location, so it may be advantageous to consider traveling for treatment.
How Much Does An Opioid Treatment Program (OTP) Cost?
Methadone is a Schedule II narcotic and under strict government regulation. Because this medication is government-regulated, the cost of treatment programs varies from state-to-state.
Some states will have more government funding and lower costs for methadone maintenance treatment programs, while others may have the opposite situation.
Several factors can influence the cost of a methadone maintenance program, including:
- location of the methadone treatment facility
- non-profit vs. for-profit centers
- inpatient vs. outpatient treatment programs
- income level of the individual
- individual health insurance coverage
For these reasons, methadone maintenance treatment costs can vary considerably from facility to facility.
There are three types of opioid substance use treatment types: inpatient treatment, outpatient treatment programs, and clinical or office-based methadone treatments.
In an emergency, naloxone is used to counteract an opioid overdose.
How Much Is Inpatient Methadone Treatment?
An inpatient treatment program’s cost includes the amenities available at the rehab facility, the 24-hour care the staff provides, and the assessments and any mental health therapy needed.
Inpatient methadone treatment requires the individual to live full-time at the drug rehab center. These programs provide 24-hour care as individuals detox and move through treatment.
Having 24-hour treatment services ensures that individuals will remain comfortable during the uncomfortable opioid withdrawal symptoms.
Inpatient substance abuse treatment typically lasts between 60 to 90 days. However, it is common to stay on an MMT program for at least a year in most cases.
Inpatient programs are still an effective way to begin to take control over an opiate addiction. Once inpatient detoxification is complete, individuals can take a referral for outpatient treatment.
How Much Does Outpatient Methadone Treatment Cost?
When using insurance coverage, individuals will typically find that outpatient treatment costs less than inpatient treatment.
There are a few different options for outpatient treatment programs, including:
- intensive outpatient treatment
- medication-assisted treatment
Intensive outpatient methadone maintenance treatment is therapy-based substance abuse treatment that involves meeting with a licensed drug counselor a few times a week.
On the other hand, medication-assisted methadone maintenance treatments use a combined approach with substance abuse counseling and medication.
However, some people may need the more intensive care an inpatient treatment program provides when starting their recovery journey since opioid detoxification can be life-threatening.
The Price Of Clinical And Office-Based Methadone Treatment Programs
Another form of outpatient treatment, office-based methadone maintenance treatments, includes medication and counseling as a part of their programs.
Office-based methadone treatment programs differ from standard outpatient treatments in that the cost of treatment does not include the cost of the medication.
Being in an office-based environment, individuals will only receive a prescription for methadone. These clinics are not legally able to dispense any medication on-site.
Are Free Or Low-Cost Methadone Clinics Available?
Although there are no ‘free’ methadone clinics, there are ‘low-cost’ and affordable methadone treatment programs out there.
Depending on the clinic, someone could pay for their treatment using private insurance, federal programs like Medicaid/Medicare, cash, or credit.
What Is A Methadone Maintenance Treatment Program?
MMT programs are used to help individuals with opioid use disorders. While methadone maintenance programs help treat opioid addiction, they are not used for other drug addictions.
When someone builds up a dependency on opioids, their tolerance has increased so much that their body physically needs the substance.
Common opioids include:
How Does Methadone Maintenance Treatment Cost Compare To Other Treatments?
There is a stigma around using this synthetic opioid as a treatment for opioid dependence. Methadone is an opioid agonist that has been well researched for decades.
Compared to other major drug treatments for opioids, methadone is the most studied and cost-effective.
The National Institute on Drug Abuse estimates the following annual total cost for outpatient treatment:
Methadone treatment with daily visits costs $6,552 a year (includes daily visits, cost of methadone, integrated psychological and medical support services).
Buprenorphine treatment with daily visits costs $5,980 a year (includes twice-weekly visits and the cost of methadone).
Naltrexone treatment costs $14,112 a year (includes drug cost and administration and related services).
Why People May Choose MMT Over Other Opioid Treatment Programs
While MMT costs more than buprenorphine treatment, it also includes daily visits and counseling to ensure individuals have all the support they need during treatment.
On average, MMT programs are also less expensive than becoming entangled in the criminal justice system, which averages a cost of $30,000 per year for incarceration.
The cost-effectiveness of methadone makes it a good choice for those with opiate substance use disorders.
What’s Included In A Methadone Maintenance Treatment Program?
Different programs will include various services.
When choosing a methadone maintenance program, items to consider include:
- the cost of methadone (whether it’s included in the treatment)
- whether the treatment is at an inpatient or outpatient treatment center
The length of methadone maintenance treatment should correlate to the needs of the individual. This is why individual counseling, especially at the start of treatment, is so vital.
Recent clinical trials have also been conducted on methadone maintenance therapy programs to determine the ideal treatment length.
Some individuals will only need MMT for a year, while others may need it for the rest of their lives.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
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- National Center for Biotechnical Information (NCBI) — Methadone Maintenance and the Cost and Utilization of Health Care among Individuals Dependent on Opioids in a Commercial Health Plan
- National Institute on Drug Abuse (NIDA) — How much does opioid treatment cost?
- U.S. Department of The Interior (DOI) — Drug and Alcohol Testing
- Food and Drug Administration (FDA) — DOLOPHINE® HYDROCHLORIDE CII (Methadone Hydrochloride Tablets, USP)