How Much Does Naltrexone Cost With And Without Insurance?

The price of naltrexone can vary a lot depending on your insurance coverage. Without insurance, a 30-day supply of the generic tablet usually costs about $100, but with insurance, the cost may be much lower or even fully covered. Some people may still pay more depending on their specific plan.

Naltrexone is a prescription drug used to help people manage alcohol and opioid use disorders. It works by blocking the effects of opioids in the brain and helping to reduce alcohol cravings, which can support long-term recovery.

Naltrexone is available in two main forms. One is a daily pill, which has both generic and brand-name versions. The other is a monthly injection given by a healthcare provider. The injectable form, often known by the brand name Vivitrol, does not currently have a generic option and is usually more expensive.

Find out more about taking Naltrexone for addiction treatment

Does Insurance Cover Naltrexone?

Many health insurance plans, including Medicare and Medicaid plans, offer coverage for generic naltrexone, brand name versions of naltrexone, or both.

Naltrexone may be covered by:

• private health insurance plans
• commercial insurance plans (i.e. employer-provided group plans)
• Medicare and Medicaid health plans
• military insurance (i.e. Tricare)

The cost of naltrexone may vary depending on the type of insurance plan you have, your insurance policy, prior authorization requirements, and the type of naltrexone received.

Cost Of Naltrexone Without Insurance

Naltrexone is a non-addictive medication that comes in the form of a pill, usually taken daily, or a monthly injection (Vivitrol). Oral naltrexone is cheaper in cost than Vivitrol, the brand name for the extended-release injectable form of naltrexone.

Cost Of Oral Naltrexone Without Insurance

Oral naltrexone is available as a generic drug, or may be prescribed under the brand names Revia or Depade. Without insurance, oral naltrexone can vary in cost from $25 to $108 for a 30-day supply of 50 milligram (mg) tablets. Factors that can affect this cost include where naltrexone is bought, the prescribed dosage, frequency of use, pharmacy coupons and discounts used, and more.

Cost Of Naltrexone Injection Without Insurance

The injectable form of naltrexone (Vivitrol) can be costly without insurance. A monthly dose of Vivitrol costs about $1,176.50 on average, or $14,112.00 per year. This estimated cost includes the cost of the drug, the administration of Vivitrol, and related services for Vivitrol administered through an opioid treatment program (OTP).

Cost Of Naltrexone With Insurance

Medication-assisted treatment (MAT) for alcohol and opioid use disorder with naltrexone is covered by many health insurance plans. With health insurance, the cost of naltrexone can be dramatically reduced, depending on the type of insurance plan you have and other eligibility requirements for coverage.

Cost Of Oral Naltrexone With Insurance

The cost of oral naltrexone with prescription drug coverage can vary depending on the health insurance provider and your insurance policy. Some insurance plans may fully cover the cost of oral naltrexone, while others may require copayment.

Cost Of Injectable Naltrexone With Insurance

Many health insurance plans offer coverage for Vivitrol, the injectable form of naltrexone. Copayment, prior authorization, and other eligibility requirements may apply. For those with copayment requirements, the manufacturer of Vivitrol now offers a Co-Pay Savings Program for eligible adults with public or private insurance. Not all health insurance providers that cover oral naltrexone cover Vivitrol. To confirm coverage, you’ll need to refer to your specific insurance policy or contact your insurer.

Factors That Affect The Cost Of Naltrexone

In addition to whether you have health insurance, there are a number of factors that can affect the cost of medications like naltrexone for substance abuse recovery.

What can affect the cost of naltrexone:

• Prescription Dosage: Higher or more frequent dosing schedules will increase your monthly medication costs. Your doctor will prescribe the most effective dose for your specific situation, but this directly impacts how much you’ll pay each month.
• State of Residence: Medication prices can vary significantly from state to state due to different pharmacy regulations, state Medicaid programs, and regional competition among pharmacies. Some states also have prescription assistance programs that can help reduce costs.
• Drug Formulation (i.e. pill vs. injection): The injectable form of naltrexone (Vivitrol) is typically much more expensive than the daily oral tablets. While the injection offers the convenience of monthly dosing and eliminates concerns about daily compliance, it comes with a higher price tag since there’s no generic version available.
• Treatment Setting (e.g. outpatient clinic, inpatient rehab program): Outpatient clinics, inpatient rehab programs, specialty addiction treatment centers, and regular pharmacies may all have different pricing structures and may offer different types of financial assistance or payment plans.
• Generic or Brand Name Version: Generic naltrexone is significantly cheaper than brand-name versions like ReVia. For the oral form, choosing generic can save you hundreds of dollars per year, while the injectable form currently only comes as the brand-name Vivitrol.
• Insurance Provider and Prescription Drug Coverage Policy: Different insurance companies have varying levels of coverage for addiction medications. Some may cover naltrexone fully as a preferred drug, while others may require prior authorization, step therapy, or higher copayments. Your specific plan’s formulary determines how much you’ll pay out of pocket.
• Pharmacy Coupons: Many pharmacies offer discount programs, and pharmaceutical companies sometimes provide patient assistance programs or coupons that can significantly reduce costs, especially for people without insurance or those with high copayments.

Not all insurance companies cover naltrexone the same. Insurance deductibles, co-payment, and other insurance-related requirements for covering costs may apply. In addition, factors such as the dosage prescribed and whether you are receiving a brand name or generic drug product can affect drug costs.

Ways To Save On Naltrexone

If the cost of naltrexone feels overwhelming, there are several ways to make treatment more affordable. Many pharmacies offer discount cards or savings programs that can lower the price of generic medications. Some drug manufacturers also provide patient assistance programs for people who qualify based on income or insurance status. Asking your doctor or pharmacist about these options can help you find the lowest available price.

You can also compare prices between pharmacies in your area, since costs can vary widely. In some cases, telehealth providers and community health clinics offer lower-cost prescriptions or sliding-scale fees. Taking time to explore these options can make it easier to stay consistent with medication and continue your recovery without added financial stress.

Naltrexone Cost FAQs

Find answers to frequently asked questions about the cost of naltrexone.

❓ Is Naltrexone Covered By Medicaid?

✔️ Naltrexone (oral and injectable) is covered by Medicaid in all 50 states and the District of Columbia.

❓ Does Medicare Cover Naltrexone?

✔️ Medication-assisted treatment (MAT) with naltrexone is covered by Medicare Part D and Medicare Part A, B, and C when administered in approved treatment settings.

❓ Does Tricare Cover Naltrexone?

✔️ TRICARE offers prescription drug coverage for oral naltrexone, which is available in generic and brand name versions.

Vivitrol, the extended-release formulation of naltrexone, is not covered by TRICARE.

❓ How Much Is A Prescription For Naltrexone?

✔️ The average cost of a prescription for oral naltrexone ranges from $20 to $109 for a 30-day supply, without insurance.

Pharmacy coupons, drug discounts, and prescription drug coverage offered through a health insurance plan may help reduce naltrexone prescription costs.