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PostPosted: Tue Aug 16, 2016 1:50 am 
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I am new to here but have been reading these forums for a while... I was wondering if anyone knew if there is any way I can get my united healthcare coverage through kraft heinz to cover zubsolv? My last job I had united healthcare and it covered zubsolv, but for some reason they don't cover any buprenorphin products. As of right now my only option is to use the copay card from orexo pharmaceuticals for my 8.6_2.1 zubsolvs. Im still paying 400 something out of pocket. Other than that im hoping my doc will switch me to generic 8mg subutex because their only 150 with no insurance for 60 of them. Does anyone know if I can write a letter of appeal or something... if anyone had any insight, or has any info I would really appreciate it.. thank you...


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PostPosted: Tue Aug 16, 2016 8:18 pm 
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What they are doing is illegal, but they know that people have little power to stop them. I recommend calling the number on your card, and asking the person how to appeal their lack of coverage. Maybe first you should make certain that no other buprenorphine products are covered... you need to ask specifically about each med, because phone workers don't usually know that Suboxone is related to Bunavail. Ask about Suboxone, Bunavail, Zubsolv, buprenorphine, and buprenorphine/naloxone.

If the person says none are covered, explain that you have an illness and those are the only medications that treat it-- and ask who you should talk to. See if you can go up the chain, gathering information. Ask each person you speak with for their name, or some other identification that you can document like an employee number.

Get the name, address, and phone number of whoever you need to speak with to file an appeal. Don't get angry during this discussion; be polite and 'matter-of-fact'. If by some chance you get to someone at a higher level-- someone who has a title-- tell that person that you have an illness called opioid dependence, and that you are covered for that illness, so you expect the medication to be covered. Provide your phone number, take the person's name, and ask when you can expect a call back about the issue. But then also ask for that person's contact info-- mailing address and phone number-- saying you want it so you can call back if you don't hear from them.

Be polite, and hold your anger. If you get angry, they will hang up and win.

When you get the info, feel free to write to me at my email at drj at fdlpsych.com . If you want, I'm happy to help write an appeal letter. Also, look up the health insurance commisioner in your state-- the place where people write to complain about insurance decisions. You may also want to write to your state assemblyman or state senator, as those people are in office, basically, for these types of issues.

Let your doc know you are doing these things, and ask if he/she will change to generic buprenorphine while waiting for this issue to resolve.

Good luck!!


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PostPosted: Wed Aug 17, 2016 6:26 am 
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I really appreciate the quick feedback.... im going to make done phone calls today and do as you said and take names down and stuff.. I will keep you posted... thank you so much


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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