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PostPosted: Sat Sep 04, 2010 9:57 pm 
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is there any possible way an insurance company could find out about your suboxone script if you pay out of pocket?

it would be in there interest because addiction is a pre existing condition


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PostPosted: Sun Sep 05, 2010 1:33 pm 
yes, they can and they do. Several people have reported on this forum that they paid for Sub out of pocket to keep it off their insurance records, only to find out that their insurance company had record of it anyway. You might as well just go ahead and let the insurance pay for it as there is really no way that I know of to keep them from finding out.


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PostPosted: Sun Sep 05, 2010 1:39 pm 
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The way they more then likely find out is through your medical records. Most if not all insurance companies require you to allow them access to your healthcare and medical records. That is how they can find out. They are obtaining the report from the doc who prescribes the Suboxone to you. Certainly if you don't have them pay for it, that will lesson the chance that they will stumble across this information. It's not like they will go looking for it absent of some claim for payment. In other words, they will not do a random audit of you. It would only be after the claim for Suboxone came through that they might start digging. On the other side of this, it could also be after a totally un-related claim that they could find out. That is sort of what happened to me. I have been asked by a couple of people to tell my story about this on another post so look for it to find out what happened to me.

Hope that helps.


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PostPosted: Sun Sep 05, 2010 2:34 pm 
In my case, it was due to the fact that the prescription was entered into the same computer system that my insurance-paid prescriptions were in. There seems to be a centralized computer system for pharmacies now, which is what prevents you from getting refills of opiates at various pharmacies, like you could in the old days without the other pharmacies knowing. I'm supposed to get my prescriptions through a mail order company, but of course, I can't get Sub this way. However, when I request a summary from my mail order pharmacy, my Sub scripts show up on it even though I don't get it through them. So, I guess this is a long winded way of saying that your insurace company doesn't have to look at your medical records to find out you're on Sub. All of your scripts (regardless of how you pay for them) are in a pharmacy database. Sorry to be the bearer of bad news, but it's best to know what you're dealing with upfront.


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