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PostPosted: Mon Feb 06, 2012 11:46 pm 
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Location: Maine
I've been on suboxone for about 4 months now. I pay $150 for the doctor visit, he does not take insurance. I'm ok with paying the $150 for the appointment. I get 60 8mg strips a month that cost me about $600 cash a month. I've been paying for it with my savings. I'm now waiting to get my taxes this month so I can see about getting insurance. I just want insurance to cover my prescription.
I'm supposed to meet with an insurance agent this month and talk to him about what plans are available. My question is what are the chances I can even get insurance to cover my prescription?
Am I going to be rejected because it's a pre-existing condition? How much is it going to cost for the insurance? I'm hoping no more than $350. I live in Maine. I've been using for the last 10 years. This is my first time on suboxone.
My doctor is very busy and I doubt I'll be one of the lucky few to get the low income treatment.
I need to do something about the cost though. I'm hoping that I can qualify for insurance. Otherwise I don't know how to afford the scripts.


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PostPosted: Tue Feb 07, 2012 1:39 pm 
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It looks like if I get anything it will be a 'Guaranteed Issue' plan. This apparently is not the greatest option for someone buying health insurance on their own. This is really the only option for people with 'pre-existing conditions' such as drug/alcohol abuse. The first companies I am looking at are Humana and Aetna. I really only care if they can give me some sort of break on the prescription immediately. I believe with guaranteed issue plans there is some sort of waiting period before they will cover any doctor visits etc.

Does anyone have Aetna or Humana on here? I would like to know what your plan is like and what sort of co-pay for Suboxone you have. My current job employs over 150 people but does not have insurance. I've worked in places with 30 employees that had insurance.

I've been reading about the new health care laws from Obama. I think all insurance companies will be required to have guaranteed issue insurance policies starting in 2014.


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 Post subject: Not to scare you
PostPosted: Tue Mar 06, 2012 12:59 pm 
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I used to work in insurance and GI policies are very expensive. They are more than the tiered normal policies. Because they have to cover everyone, they need to price them accordingly. You are asking the insurance company to immediately cover $600/month in Rx costs. Chances are the insurance will be more than that. When I moved to NV, I lost my CA insurance. I was paying $170/month. The policy they offered (because of my recent shoulder surgery) was a GI and was $640/month. I was 34 at the time. Part of the reason I wanted off the pain meds was so I could get health insurance again. I hate not having it but I am not willing to pay almost $700/month to get it.


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PostPosted: Thu Mar 15, 2012 11:36 pm 
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Thanks for the info. I met with an insurance agent who wanted to sign me up for $300 a month plan that wouldn't cover my prescription at all. I ended up getting into some weird non-insurance group called AFS. Americans for Financial Security I think. It's not bad, for $20 a month I get 60 suboxone strips for around $400 as opposed to $600 without the card. That was the best I could do. I'm working 2 jobs just to pay for prescription and doctor visit. And the $125 for the urine test I just found out. It's cheaper on the streets. If I could buy them easily on the street I would probably stop paying the $700 + a month for them. It would be amazing if I could actually quit and have that money. But I know there's no way I could work 2 jobs without them. It's like some sick catch 22.


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PostPosted: Fri Mar 16, 2012 12:36 am 
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i was paying 175 a month doctor visit, but my meds are free with AETNA insurance, 40 doller co pay, but i have a 45 doller soupon for each month, so it ends up having a 0.00 balance, i just moved and found a doctor in the ghetto of DC that takes insurance, shes amazing and is dumbfounded how some doctors cahrge 150 a month , she thinks its a joke, and it is, but im letting your know AETNA covers suboxone.. good luck sir after reading you spend almost 1000 a month on drugs im blessed to pay only 50.. but im a cheapo so if i didnt have unsurance theres no way id be on 16mgs a day,, would go down to 4 mg , wich is very easy to do// ttyl bud


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PostPosted: Wed Apr 18, 2012 1:57 am 
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Oclafsti brings up a good point - you could try to lower your dose. At 16 mg you're very much over the ceiling and you might be able to drop your dose in half and still be just fine. And imagine how much $$ you could save! Many people cut their dose to save money.

Obviously you'll have to be on the lookout for cravings. And although 8 mg is still above the ceiling as well, if you do decide to lower your dose, you might want to consider doing it slowly just to be on the safe side. It's worth considering it.

Have you asked your doctor if s/he has any slots open in the patient assistance program? If they don't, I would ask when the next slot will be open, and then ask to be put on the waiting list.

Good luck and I hope you can get some insurance coverage soon. I find it disgusting that so many people in this nation go without basic medical care because of a lack of health insurance. It's downright shameful.

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