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.
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:
- District of Columbia
- Puerto Rico
- Rhode Island
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.
Published on July 29, 2021
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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- Substance Abuse and Mental Health Services Administration (SAMHSA) — Medicaid Coverage of Medication-Assisted Treatment for Alcohol and Opioid Use Disorders and of Medication for the Reversal of Opioid Overdose
- The Urban Institute — Medicaid Prescriptions for Extended-Release Medications to Treat Opioid Use Disorder: State Trends from 2011 to 2018
- U.S. National Institute on Drug Abuse (NIDA) — How much does opioid treatment cost?