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PostPosted: Sun Jan 08, 2012 2:34 am 
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I recently just switched insurance from Blue Cross to United Health Care. BC pretty much covered the price of my suboxone and was about $75 for 60 8mg strips. In order to get the coverage I had to provide BC with a drug test and several other pieces of information every three much. Doing this was pretty much a hassle and took forever for them to pre-authorize it each three month period, but I am thankful I do have insurance. They never informed me that the 3 month period ended in the middle of Dec. and I was damn close from not having any. Because it takes so long for them to re authorize it my Dr. gave me a script for subtext until the change was official. From what he told me and most things I have seen on these forums the price is $3-$4, but at a Walgreens in Atlanta I paid about $80 for 15 all out of pocket, which seemed odd. Anyways, starting January 1st, UHC started coverage. I was worried about them not covering suboxone or it taking time for it to go into effect. After calling UHC I was informed there is no pre-authorization required. I was so happy to learn this that it was going to be a smooth transition. I went on their website just to see their regulations on it. I found a document that lists tons of medications and their supply limits. Now I am kind of worried because their listed limit for suboxone is 93, but I can’t find anywhere if that is for a month, 3 months, a year, etc. Does anyone who has UHC aware of the supply limit? Also I was wondering if anyone might know why the generic subutex was so expensive. Thanks in advance.


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PostPosted: Sun Jan 08, 2012 2:41 am 
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Also, here are the links:
https://www.unitedhealthcareonline.com/ ... Limits.pdf

https://www.unitedhealthcareonline.com/ ... 10b10a____


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PostPosted: Sun Jan 08, 2012 3:12 am 
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if you only got 15 of the generic subutex, thats probly about rite. when I was getting them,, the less you bought at one time, the more they went up in price. and the more the lower.....

with ur insurance, my guess would be 93 is probly the limit for a 30 day supply, becuase Im on the patient assistanc e program from RB, and they say the Max a doctor is sposd to write is 93 for a 31 day supply.

but im just guessing

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PostPosted: Sun Jan 08, 2012 6:18 am 
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From what i'm seeing, these limits are for a 31-day supply of the meds.

Also, it says "per co-pay" in a few places, so that would mean, monthly.

They can't limit you per year or nothing like that...this is the most they'll pay for in one month. 248 Oxy's per month...which is 8 per day..which is 1 pid 3 hrs.


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PostPosted: Sun Jan 08, 2012 3:03 pm 
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Hi all! Actually they can limit you per year. My insurance capped out at 1400 dollars per calendar year, so I had to pay out of pocket after that. Forget Walgreens, go to rite aid and ask for a prescription card. Generic sub is a little over 3 a piece , but if purchased in quantity(30 or more), they are a little under 3.


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PostPosted: Sun Jan 08, 2012 4:10 pm 
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I also saw that Jonathan but wasn’t sure what that meant exactly. I'm pretty sure it’s every month too but just wanted to get more info on it. I thought there was a higher chance it was for every three months than a year, or some sort of set period they have. Thanks for your info guys, I appreciate it. Also I never re-read my post before I submitted it, so sorry about all the misspelled words. I was so sleepy and spellcheck is part to blame for that one


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PostPosted: Wed Nov 21, 2012 12:07 pm 
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i too had issues when i switched insurance companies to Aetna from BCBS. for the past year i was getting a certain amount every month with BCBS and when i switched to Aetna they cut my supply by 30. my doctor and i tried to appeal it but Aetna feels they know more than my doctor. i had to wean myself down in a moments notice and i told the insurance company that if there are medical complications due to the sudden taper than i may have to be hospitalized and would they be willing to pay for that. insurance companies are very frustrating. but in the end i am grateful for suboxone giving me my life back.


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PostPosted: Thu Aug 07, 2014 4:44 pm 
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I'm also on United Healthcare insurance and they require me to jump thru those prior authorization hoops except it's every six months and/or if my doctor changes the dose. Currently I've been waiting five days for it to go thru after being switched from 4mgs to 3mgs and my doctor making me switch from Walgreen's to Rite Aide. The pharmacy gave me a 5 day supply but said even if the authorization goes thru they can't finish filling my meds until the 5 days is up. Also they'll only cover a year of treatment/Suboxone. After that you're on your own. It's not a problem other than wanting to get it over with at one time. So, I totally understand the hassle of insurance companies. :/

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