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PostPosted: Fri Oct 24, 2014 6:14 pm 
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I know this post is older, but if anyone runs across it I wanted to share my experience with UHC forcing the switch to Zubsolv.

I tried the Zubsolv when this initially happened. I was on it for a week at which point I switched back to Suboxone strips and began paying out of pocket. I did this for 2 months I think? before submitting my appeal to UHC to cover Suboxone for me. The reason it took so long is because at first my doctors office (after much pushing, begging and pleading) submitted something (they said an appeal) to UHC via the fax number I gave them that is the appeals dept. Well, UHC sent me a letter with blanks on it, made no sense. I called and asked what it was and they said it was sent because although my doctor sent something to appeals, it didn't say the word "appeal" on it.

Well, my doc refused to send anything again. So I was stuck sending it myself. I put down in detail why I couldn't take zubsolv (medical issues listed). I just got a letter today telling me they denied my appeal :( Reason being? Because there is "other medication" available that does the same thing as subxone. Obviously I'm paraphrasing and obviously they are referring to Zubsolv. So I don't get that...they must not have read my appeal.

I called and asked for a hearing. According to this letter, that is the next step available to me. I am not optimistic at this point. They clearly are dead set against covering Suboxone. There is something seriously wrong with that. I'm going to do everything I possibly can and take this to the furthest extent possible.


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PostPosted: Thu Jul 30, 2015 7:08 pm 
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It is July 30, 2015. Since UHC decided they weren't covering Suboxone anymore I have tried all the other generic and non generic zubsolv to no avail. Nothing is working!! I am hardly maintining on a generic formula because I have no other choice.
Is there anyone who has successfully appealed to UHC and been able to get suboxone again?
It has been a long hard road since UHC decided to take kick backs from the zubsolv people.
I am at the end of my rope and need some assistance! PLEASE!


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PostPosted: Sat Aug 22, 2015 8:16 pm 
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I have UHC, and am still covered fully for Suboxone. I have also found no evidence of a "kickback." Is there proof of the allegation out there sonewhere?


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PostPosted: Sat Aug 22, 2015 9:58 pm 
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noleheel1 wrote:
I have UHC, and am still covered fully for Suboxone. I have also found no evidence of a "kickback." Is there proof of the allegation out there sonewhere?


It must depend on the company your UHC insurance goes through- in other words, the company you work for.
My husband works for a giant company out of Atlanta and we received a letter when they decided they weren't going to cover sub films anymore- only 30 days prior to the date of rescinded coverage. My Dr is a Neurologist- he explained how the zubsolv makers made a deal with UHC once the patent ran out on suboxone- now any company can decide they want to make this med, of course they have guidelines but they aren't as stringent as brand name drugs- zubsolv is a branded generic- whatever that means- so they claim it works just as well as original sub film but I know for a fact I have had nothing but issues since coming off the films and trying zubsolv and other generic versions-
I just picked up my last script which was from Kroger and the copay was $0.00.... How in the world did suboxone film go from $$$ to a generic that costs nothing? And they mean to say the drugs are identical??? No way.


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PostPosted: Sun Oct 18, 2015 10:04 pm 
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I have an update for myself. Last month I submitted my RX to my Rite Aid Pharmacy as usual. My wife went to pick up and was told UHC denied coveragr. I thought if this thread and investigated. They had changed the drug level to make it where I had to have prior authorization. I was annoyed due to having no notice, but was able to expedite request and get authorization in 2 days with no trouble.


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PostPosted: Fri Feb 26, 2016 1:48 am 
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YES THEY WILL COVER IT..... :D

HI.. i only read a little of the way through.. i actually was on GENERIC SUBUTEX{and still am}..not SUBOXONE as i dont need it..SUBUTEX is fine... but all of a sudden my pharmacy doesnt have it and no one around me..BUT THEY HAVE THE FILMS EVERYWHERE!!!! UHC denied FIRST PA...

- its a stupid reason for denial i read above a few times about being in an active program...this ons is easy and my doc just told me he would take care of it...and i guess he did

SEE-.. simply the doctor your seeing for your subxone and let him know how your doing and ectect.. IS A PROGRAM!!.... {what i mean is i have been in to many "out of stock" situations ectect..}

anyway--long story short..today my one year approval number for FILMS came in{just today!!}..BUT..my subutex is being filled!!!!.. the APPROVAL CANT HURT--another way of being prepared ..

if i can ill never get the films as you only get 60... i need the 90 subutex!

i see my doctor almost every 4-5 weeks.. so im sure that also solved the issue of "program"..

OK I RAMBLED ON AND ON but i have been on all forms but liquid since 2008..need help hit me up...

{FOR REFERENCE I PAY 2.95$ for 60 films.. thats my highest copay.. the rest are 2.45 ..

OH AND STAY ON YOUR DOCTOR maybe once about the PA and make sure its 'EXPEDITED"..if its not thats where months come in! BESIDES THAT..HE DID ALL THE FACING AND ALL HE WAS SUPPOSED to he faxes stuff and UHC send you the determination--either NO AGAIN--OR with approval code.

_________________
i am currently on Suboxone films.
i have had Suboxone pills.
i have had Subutex.{only come in pills}
i have had generic subutex.{Buprenorphine}
http://suboxone.com/patients/here_to_help/copay.aspx BEST DEAL ON WEB THAT I KNOW OF!


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