Does Medicaid Cover Vivitrol?

Vivitrol is a long-acting, injectable medication that is covered by Medicaid in all 50 states and the District of Columbia (D.C.). Eligibility requirements, including an FDA-approved diagnosis, may apply in order to receive insurance coverage for Vivitrol.

Does Medicaid Cover The Cost Of Vivitrol?

Vivitrol (naltrexone) is a prescription medication for alcohol and opioid use disorder. It is covered by Medicaid health plans in all 50 U.S. states and the District of Columbia.

Eligibility requirements for receiving Medicaid coverage for Vivitrol may vary according to your state of residence and the type of Medicaid coverage plan you have.

Read more about using insurance to pay for Vivitrol

Medicaid Insurance Coverage For Vivitrol

Vivitrol is an extended-release, injectable form of naltrexone that is received in the form of a once-a-month shot. It is FDA-approved to treat alcohol and opioid use disorder.

Vivitrol is prescribed alongside other support services as part of a medication-assisted treatment (MAT) program—the first-line treatment for opioid use disorder.

From 2011 to 2018, the number of prescriptions for Vivitrol increased 30-fold, from 7,474 in 40 states and D.C. in 2011 to over 261,000 in 49 states and D.C. in 2018.

Is Prior Authorization Required For Medicaid Coverage Of Vivitrol?

Prior authorization for Medicaid coverage of Vivitrol is required in 15 U.S. states, the District of Columbia (D.C.), and Puerto Rico, as of 2017.

States and territories that require pre-authorization include:

  • Colorado
  • District of Columbia
  • Florida
  • Idaho
  • Kentucky
  • Louisiana
  • Maryland
  • Mississippi
  • Minnesota
  • Montana
  • Nevada
  • Ohio
  • Puerto Rico
  • Rhode Island
  • Tennessee
  • Texas
  • Utah

Prior authorization requirements may apply in states not listed here. Prior authorization is a process that can be initiated by a primary care physician for medication approval.

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How Much Does Vivitrol Cost With Medicaid?

The cost of monthly Vivitrol shots with Medicaid coverage can vary.

A single Vivitrol prescription costs about $1,200 a shot, before adjusting for federal basic and inflation rebates.

But with Medicaid coverage, pharmacy coupons, and drug discounts, this is not a cost you may be responsible for covering by yourself.

To learn how much Vivitrol costs with your Medicaid plan, you’ll need to refer to your individual policy or contact an insurance representative for more information.

Who Is Eligible For Vivitrol?

Vivitrol is an addiction treatment medication that is prescribed for alcohol or opioid dependence in adults over the age of 18.

In order to receive Medicaid coverage for Vivitrol, a clinical diagnosis of an alcohol or opioid use disorder may be required.

Call Today To Find Vivitrol Treatment Near You

Vivitrol is an extended-release medication that can help people in early recovery from alcohol or opioid addiction maintain their sobriety.

If you’re looking for addiction treatment for yourself or a loved one, call our hotline today to speak with a specialist about finding a treatment program that’s right for you.

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