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PostPosted: Wed Apr 20, 2011 6:58 am 
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My mother is having trouble finding a insurance company that will pay for her suboxone. She is on disability and has Medicare. She did have AARP but 2 months ago they quit paying for Suboxone. Thry did give a 6 month warning. Now the insurance she has paid for it for 2 months and don't want to pay for ir anymore after agreeing when she signed up. She take 3 8mg suboxone a day. She can't afford 600 $ a month. She on;y gets around 750 $ a month on her SSI Diability. If she is can't find a insurance to cover it I am afraid of the severe withdrawl she will endure. This is my mother and Suboxone saved her from Opiate addiction. She has been on Suboxone a very long time. I need to help her find a insurance company that will cover Suboxone immediately. PLEASE HELP! Thank You!


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PostPosted: Sat Apr 23, 2011 12:25 pm 
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That is sad and very sorry to hear this.... but I bet she could cut her dose down dramaticly without issue and thiis would save her a lot of monies. I didnt feel the difference at 8mg from 24mg.. I felt better at 2mg. why so high a dose?


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 Post subject: Damn Insurer Stories
PostPosted: Mon Apr 25, 2011 1:21 am 
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[b][i]

I'm so sorry to hear about others experiencing problems with there Ins. paying for there Suboxone.

I'm in the process of appealing my Ins. which is Humana/Medicare. The book says it pays for it then they tell me that I can not take narcotics for them to pay for my Suboxone. I'm aware of this.
I had to buy 1 week of them and there is no way I can afford to pay for anymore. There is also no way I can see me getting off the pain meds without the Suboxone.

If anyone has any sugesstions on this please I'd love to hear them.
I also have Lupus and a history of seizures so to go thru W/D will not be pretty. The seizures were not from the pain meds I actually had them when I was clean....Go figure.

I'm so thankful to have found this site.

Marie


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PostPosted: Tue Apr 26, 2011 11:09 am 
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Marie, I agree. It would be hard to deal with withdrawls and Lupos and seizures all together. I don't understand why they have her on such a high dose other than to have a hold on a person so that they have no choice but to keep coming back. But the worste part is giving addicts this kind of medication and then insurance companys just tell you out of the blue that they aren't gonna pay for it any longer. I told my mom to be cutting down her dosage and prepare herself in case they don't cover it this month. I'm hoping they just want a pre authorization.
Thanks for the input and suggestions. I wish everyone the best in their journey.


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PostPosted: Tue Apr 26, 2011 6:16 pm 
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Mikepaperchaserb,

Has your Mom tried to appeal the decision that the Ins. Co. has made for her?

After a week I'm still fighting with the Ins. Co. It looks as though my Dr.'s office has been part of the hold up.
I've been waiting around to hear from my Dr. office and damn sure enough I went out to water my plants and they called and refuse to call me back. She said they sent the paper work off this morning. I wanted to ask just exactly had she told them but it will take another week or me going back up there to get a answer.
I'm just disgusted with it all.
The Pharmasist told me he hasn't seen alot of approvals on Suboxone lately. That was probably the last thing I needed to hear b/c since then I've been really down.
I don't know what the future holds for me but it's not looking good.

Good luck with your mom..

Marie


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PostPosted: Tue Apr 26, 2011 8:42 pm 
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these posts seem so depressing. the fact that insurance companies dont wanna pay for a drug that actually helps people just pisses me off. I can feel peoples pain and dissappointment in their posts. It's messed up they the insurance companies and medicare and medicaid will pay for oxycontin, and all the othe addictive meds that started all these addictions in the first place but won't pay for a drug to help people get off the narcotics and keep people from stealing and robbing and chasing drugs in the streets


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PostPosted: Tue Apr 26, 2011 11:19 pm 
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Mikepaperchaserb,
I'm so sorry to hear that your Mom is having such problems with her insurance. I don't know anything about Medicare and the need for a supplemental insurance coverage. Does Medicare on its own not cover suboxone for addiction? The healthcare/insurance system is such a mess, in my opinion. I do not understand why an insurance company would choose not to cover suboxone when the likely outcome will be patients with far more severe medical problems resulting from opiate abuse. I am fortunate enough to belong to a large HMO (Kaiser) which places a lot of emphasis on preventing chronic disease from progressing. I have been in their addiction recovery programs in several locations in Northern California and their focus is on addiction as a chronic disease that is progressive and deadly if not treated. Their buprenorphine maintenance program is awesome and I really don't understand why more medical organizations don't embrace their model. Anyway, if Kaiser is an option in your area I would definitely look into it and see what the evidence of coverage for available Medicare plans covers as far as chemical dependency treatment.
The other thought I had is to ask your Mom's doctor if he or she would consider prescribing Subutex rather than Suboxone if this issue continues. The out of pocket cost of *generic* Subutex is generally far less than Suboxone. It's definitely worth inquiring about if you have not already done so.
Again, I am so sorry to hear about the problems you are having and I hope everything works out soon.

~Anna


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