How Much Is Subutex? | Is Subutex Covered By Medicaid/Medicare, Private Insurance

Subutex is a medication that helps people recover from opioid addiction. It contains a drug called buprenorphine that reduces cravings and withdrawal symptoms. The price you pay for Subutex depends on your insurance situation. If you have health insurance, your plan might cover all or part of the cost. Without insurance coverage, you’ll need to pay for Subutex yourself, which can be expensive.

However, there are ways to get help paying for this medication. Drug discount cards and other financial assistance programs exist to make Subutex more affordable for people who need it.

Learn more about the benefits of Subutex in medication-assisted treatment

Cost Of Subutex

Subutex pills may cost up to $310 without insurance, according to average retail price estimates. This average retail price is for generic Subutex tablets. With insurance, the cost of Subutex may be fully or partially covered. You may be responsible for copays or out-of-pocket costs, depending on the stipulations of your insurance policy.

To be eligible for Subutex drug coverage, you may be responsible for paying monthly premiums and meeting plan deductibles prior to purchasing Subutex for medication-assisted treatment.

What Factors Can Affect The Cost Of Subutex?

The cost of Subutex for opioid dependence can vary according to a wide range of factors.

The cost of Subutex may depend on:

• how you plan to pay for Subutex (e.g. self-pay, private insurance)
• type of insurance plan
• state of residence
• pharmacy location
• treatment setting
• dosage amount
• supply

Health insurance is one of the primary factors that can affect how much Subutex costs, in addition to the dosage and amount of pills/tablets in the prescription.

Is Subutex Covered By Medicaid?

Medicaid can cover Subutex (buprenorphine) for people who are being treated for opioid addiction. However, coverage isn’t the same in every state. Each state runs its Medicaid program differently, so some plans cover Subutex while others might not. According to the Kaiser Family Foundation, 21 states required patients to pay a copay for buprenorphine as of 2018. Your state might also have other rules or limits on how much Subutex you can get.

It’s important to check with your specific Medicaid plan to find out exactly what they cover and what you’ll need to pay out of pocket.

Is Subutex Covered By Medicare?

Some Medicare plans, including Medicare Part D and some Medicare Advantage plans, may offer drug coverage for Subutex. This will depend on the type of Medicare policy.

Proof of medical necessity, copays, and other eligibility requirements may apply in order to have drug costs covered.

Is Subutex Covered By Private Insurance?

Generally, yes. The majority of insurance providers in the United States offer insurance plans that include some level of coverage for opioid addiction medications like Subutex.

Cost Of Brand Name Vs. Generic Subutex

Subutex is a brand name for buprenorphine, the generic equivalent of Subutex. Generic buprenorphine tablets can be cheaper in cost and therefore more cost-effective for MAT.

The cost of generic Subutex vs. brand name Subutex may depend on the type of insurance plan you have and whether Subutex is listed as a covered medication.

Can You Pay For Subutex Out Of Pocket?

You can pay for Subutex out-of-pocket, but this may be costly. Without insurance, a monthly supply of Subutex could cost hundreds of dollars out-of-pocket.

Financial Assistance For Getting Subutex

Many people have issues affording Subutex treatment, even though they need it to recover from opioid addiction. The good news is that several programs exist to help make this medication more affordable.

Ways To Reduce Subutex Costs:

• Manufacturer Discount Programs: The company that makes Subutex may offer savings cards or coupons that lower your prescription costs. These programs are often available on the manufacturer’s website.
• Prescription Discount Cards: Free discount cards from companies like GoodRx or SingleCare can save you money at most pharmacies. You can use these cards even if you don’t have insurance.
• Assistance Programs: Some organizations help people who can’t afford their medications get them for free or at very low cost. You usually need to meet certain income requirements to qualify.
• Sliding Scale Payment Options: Many addiction treatment centers charge based on what you can afford to pay. They look at your income and family size to determine your cost.
• State-funded Treatment Programs: Your state may have programs that provide free or low-cost addiction treatment, including medications like Subutex.

Money should never be the reason someone can’t get the treatment they need. Talk to an addiction expert or reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information.

Finding Affordable Treatment Centers

Cost is one of the biggest reasons people don’t get help for opioid addiction. However, treatment doesn’t have to be expensive. Free and low-cost rehab centers exist in most areas across the country. Community health centers often provide addiction treatment on a sliding scale. Nonprofit organizations also run treatment programs specifically for people without insurance or money. Taking the time to research local options can help you find quality care that fits your budget.

Written by the Addiction Resource Editorial Staff