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PostPosted: Sat Feb 11, 2012 12:13 am 
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Hi Everyone - I'm really new to this forum and have been reading through all of your posts over the past week or so. First, just to give you a little background, my husband and I have been on Suboxone since December 2010. Prior to suboxone, we were on methadone for about a year and a half. So we've basically been in recovery for almost 3 years.
I've noticed that many of the people who post on this forum see their doctor every 3 months. However, our doctor requires monthly visits. Neither of us has ever had a dirty urine screen in the 14 months we've been seeing our doctor and we both are doing well. What I am wondering is if their is maybe a state specific law that requires sub patients to see their doctors monthly?
I would love to only have to pay for my doctor visits every three months, instead of every single month! Especially since there are two of us seeing the doctor each month. We have health insurance through my work, but the deductible is way too high (and using my insurance to try to reach my deductible would result in me paying about four times as much each visit instead of just paying the "cash patient" rate) so we pay $80 ($160 total for both of us) a month for the office visit. And then, of course the medication cost is pretty high (and no, my crappy health insurance won't pay for this either because it won't cover maintenance drugs). Basically, I was just wondering if anyone could tell me how long it took them to get their office visits every 3 months instead of once a month? As I mentioned earlier, I've been seeing this dr for 14 months with clean urine screens and also have been slowly tapering down my dose of suboxone since I started it. I started at 16 mg's per day and am now at 6mg's and trying to get to 4 mg's. Does the amount of suboxone you are prescribed have anything to do with the amount of time between visits to your doctor? Is this something that would vary from state to state? Or maybe just doctor to doctor? I do feel a certain pressure to continue to taper my dose of sub, so maybe that's why my dr. wants to see me monthly, but at this point I'd rather not taper off my dosage for a little while. If I could cut my visits down to every three months, this would be very helpful financially. I would appreciate any input anyone has to offer! Thanks!


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PostPosted: Sat Feb 11, 2012 6:10 am 
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Well, it depends on the doctor, and the drug being given. I have no clue how long a doctor can give out methadone, but I suppose if he writes it for pain, then he could do 3 months.

But Suboxone is written inside a doctors office, and the doctor in that setting can write 3-month amounts unlike the methadone clinic.


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PostPosted: Sat Feb 11, 2012 7:00 am 
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Hi, JenW-

I have been a Suboxone patient- with the same sub doc for almost 7 years (yes, I know that this
is a long time, but that is a whole other topic ;-)

Anyway- to answer your original question- it had taken me about 2 years before I could get every-
other-month visits with my sub doc. And- for what it's worth- I am paying the same amount that you
are for my office visits, too. However- since I am disabled, Medicaid has been paying for my Suboxone-
but I have to go to counseling once every two weeks, and also come up clean for my in-office- as well as
random- drug screens (which has not been an issue for me).

By the way- if you check on my "profile" on here- you can see that I am in PA...

So, I really can't tell you exactly how long that it would take for you and your husband to "progress"
to once-every-three-months visits with your particular sub doc. As you can tell- I've been with mine
now for almost 7 years- and still haven't made it that far- and don't really think that I will- to be honest.
And- I really have no idea why this is that way. I hope this helps you at least a little bit! :)

With all of that said, I'm sure that a few other people on here will probably come along to chime in,
with some of their answers/ experiences, as well.

Good luck!

Thanks,

-ex-


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PostPosted: Sat Feb 11, 2012 1:11 pm 
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It depends on the doctor, I see my doctor once a month at $100 a visit plus my meds.. I have no insurance. I asked her in the past about seeing her every other month or every 3 months to save money too but she told me that I have to be seen monthly as long as she is my doctor, She said if I wanna see a doctor bi-monthly or every 3 months then I would have to find a new doctor willing to do that. Basically it has nothing to do with state law or how far in your program you are or even how long you've been on the meds.. it depends on your doctor and what their policies and rules are, all you can do is ask. Theres no law or policy requiring your doctor to let you do the every other month or the once every 3 month visits.. its all up to the doctor.

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PostPosted: Sat Feb 11, 2012 2:13 pm 
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sodone wrote:
It depends on the doctor, I see my doctor once a month at $100 a visit plus my meds.. I have no insurance. I asked her in the past about seeing her every other month or every 3 months to save money too but she told me that I have to be seen monthly as long as she is my doctor, She said if I wanna see a doctor bi-monthly or every 3 months then I would have to find a new doctor willing to do that. Basically it has nothing to do with state law or how far in your program you are or even how long you've been on the meds.. it depends on your doctor and what their policies and rules are, all you can do is ask. Theres no law or policy requiring your doctor to let you do the every other month or the once every 3 month visits.. its all up to the doctor.


This pretty much sums it all up...Most doctors do monthly so they can keep a closer eye on their patients and how they are doing.
Some don't mind it, and reiterate that if you have ANY questions you should not hesitate to call them, others just go with the most common approach, which is seeing their patients monthly.

I got to admit, this doctor I'm seeing now is the very first that I've had the liberty of visiting who allowed me once every 3 months. All others wanted a MUCH closer visitation schedule or follow-up. I've even been to one that had me on weekly for 2-3 months, then bi-weekly for 2-3 months, then monthly for 4-6 months, then MAYBE monthly...but i never got past the weekly part because I couldn't afford to pay the guy $160 PER WEEK...it was like highway robbery to keep me clean. I can't see where doctors can sleep at night knowing that addicts have depleted every resource they have and come to them as a last ditch effort to save their lives...and willingly make them pay like that. All don't, but the problem is SOME do.


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PostPosted: Wed Feb 15, 2012 4:07 pm 
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I am new to the forum, and since I am on my second doc, I might be able to add a bit. I've been on suboxone, for about 4 years. My first doctor allowed me to extend time between appts. to three months. This was after seeing him for about 4 months, every month. The present doc won't extend the time past one month. I did a little research online and found that there is a vague government recommendation of one month. I pay $150(!) a month (cash only) for each visit (about 10 minutes). There was a intake fee of over $600. I don't like to complain, as this drug has changed my life to worth living, but there is a lot of money being made. The first doc said that prescribing subs raises his insurance costs a lot , but HIS intake fee was only $150 and $120 each visit after that. (every 3 months). So yes, it is up to the doctor, but some will allow more time between visits after you prove yourself. So if you are thinking about trying suboxone, beg, borrow, (but don't steal), DO IT, it will change your life, but be prepared to visit at least once a month.


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PostPosted: Wed Feb 15, 2012 7:05 pm 
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jimbob wrote:
I am new to the forum, and since I am on my second doc, I might be able to add a bit. I've been on suboxone, for about 4 years. My first doctor allowed me to extend time between appts. to three months. This was after seeing him for about 4 months, every month. The present doc won't extend the time past one month. I did a little research online and found that there is a vague government recommendation of one month. I pay $150(!) a month (cash only) for each visit (about 10 minutes). There was a intake fee of over $600. I don't like to complain, as this drug has changed my life to worth living, but there is a lot of money being made. The first doc said that prescribing subs raises his insurance costs a lot , but HIS intake fee was only $150 and $120 each visit after that. (every 3 months). So yes, it is up to the doctor, but some will allow more time between visits after you prove yourself. So if you are thinking about trying suboxone, beg, borrow, (but don't steal), DO IT, it will change your life, but be prepared to visit at least once a month.


It takes quite a bit of trust from the doctor to allow a patient 3 months between visits. You basically are free to do as you please, and could really fall off the horse within a 3 month period..well hell, to be honest, you could fall of the horse quite a few times, and climb back on...but NOT doing that is what keeps that relationship with the doctor at it's highest level, plus it gives the patient a sense of pure responsibility...something that us addicts have previously faltered with.

I would recommend trying your best to find one of these doctors who will go longer periods with proven responsibility. This will give you the most benefit, plus give you a sense of accomplishment to have a doctor that will go along with that. Don't give up, just keep calling and asking.


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PostPosted: Wed Feb 15, 2012 9:53 pm 
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thanks everyone for your input on this. So I've learned that the time between visits will vary per doctor. Makes sense... And its not that I mind going to see my doctor monthly - although 30 days seems to roll around rather quickly these days - its more of a financial thing, as everyone here can surely understand. And since my insurance is high deductible, I'm responsible for payment (and there are two of us, my husband and myself) up to $6000 before I get any benefit. This is why I prefer to be a "self-pay" patient because my visits are $80 instead of what they would be if went through insurance - which would be more like $250. Speaking of insurance, mine only assisted with my prescription for sub for a month! I of course had to get an authorization to use my benefit and then got a letter from my insurer stating that they would only pay for 30 days, which should give me time to "discuss a taper down plan with my physician" so I could get off the medication. What the hell? Yes, I know this topic belongs in a whole other forum but I wonder if anyone else had this issue with their insurance? I'm not sure if anything changed for this calendar year, but i wonder if there's anything i can do about this. And I also wonder if using insurance for suboxone is going to hurt me in the long run since health insurance companies are notorious for using your health issues against you for the rest of your life.... ie - never being able to get insurance again once you have a substance abuse dx, or charging an extremely high premium, etc. I know, this isn't for this forum. I'm just lucky that my husband and I have remained employed at the same jobs through all of our addiction (prior to treatment to current)... I don't know how we did that, but i do feel like we were lucky. If we weren't employed, i don't know how we'd ever afford our suboxone treatment! I'm grateful, that's for sure. Sorry for getting so off topic but I'm pretty darned new here and have lots to say and lots to ask, I guess. I'll make sure from now on that I post relevant topics in the appropriate areas. Thanks again everyone for your input and responses.


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