Find a doctor that prescribes Suboxone or similar medications
Buprenorphine containing medications for opioid addiction treatment can only be prescribed by medical doctors who have obtained a waiver certificate from DEA.
If you have insurance then it is best to call your health insurance carrier to find out if substance abuse treatment is covered under your policy … and which doctors are in your network.
Your insurance carrier approves and contracts with doctors to provide these services. If you are unable to enroll with a doctor provided by your insurance then you should find out from your insurance as to how will you get reimbursed for your expenses.
Then you have to find a doctor who is willing to help you with the billing part. Many doctors don’t, because patients come and argue with the doctor when insurance does not pay.
You can find a physician in your area by following these links. You can search for a physician by city/zip codes.
or call 1-866-973-HERE (1-866-973-4373) (Service run by the manufacturer of Suboxone)
or call 1-800-662-HELP (1-800-662-4357) (SAMHSA’s National Help Line, available 24/7)
The NAABT site lets you post your need for treatment anonymously, which is then e-mailed to area physicians who have signed up for this service, and they would reply via e-mail. You can review their responses by logging into this site.
- Visiting Addiction/Suboxone forums on the internet, and reading patient’s experience of therapy, … most of them are helpful, and they may post, or give you their physician’s name.
- Attending Narcotics Anonymous meetings and asking attendees how they managed their problem, what resources are available in the community, and which physician is treating them.
- The local pharmacists know the names of Suboxone providers in the community, because they receive prescriptions for dispensing it.
- Addiction counselor’s may know the names of area physician’s who are prescribing Suboxone.
- Only a physician with DEA waiver can prescribe Suboxone for outpatient use. Each Suboxone provider is allowed to enroll up to 100 active patients. This limit is imposed by Federal Law. A provider may not be accepting new patients if they have reached their limit.
- Some providers accept insurance, but most do not accept it, because insurance coverage is patchy with no clear policy, and is restricted to approved psychiatrists, addiction specialists, or addiction programs. The majority of Suboxone prescribe-rs are not psychiatrists or addiction specialists, … most of them are internists, family practice doctors, or pain clinics.
- Methadone cannot be prescribed by physicians for addiction treatment. It can only be obtained through approved Methadone clinics.
- Methadone can be prescribed for pain management, however most physicians are reluctant to prescribe it due to increased incidence of misuse and death.
Emergency Detox in a hospital.
It is covered by most insurances including Medicare … but you can not do it again and again. Doctors in a hospital do not require DEA waiver certificate as they are not prescribing it for outpatient use … it is only for administration while in the hospital, and is limited to short duration, generally one to three days.
What is inpatient Detox?
Inpatient Detox requires admission to a hospital. An IV is started, patient is given antianxiety and sedating medications, … and additional medications to control withdrawal symptoms as needed.
After 12 to 24 hours patient receives Buprenorphine (the active ingredient of Suboxone) as needed to control withdrawal symptoms. The dose is rapidly reduced to 2mg to 4mg over 3 to 7 days depending on the length of the program.
Patients are then discharged and instructed to continue treatment through an outpatient Suboxone program. The cost is about $1000 per day.
Detox sounds like they do some procedure by which they remove the toxins from your body … not so. It is merely a very expensive inpatient controlled withdrawal, and sometimes induction of Buprenorphine.
This is not a good method … after detox and discharge from hospital you will be back in withdrawal.
It is covered by most insurances. It is best to enroll with a Suboxone provider before you go for in-patient Detox. This way you can continue your treatment without a break. If you do not get Suboxone prescribed … then you will have withdrawal, and will be at risk for relapse.
Looking for a doctor after you are discharged from the inpatient program may take time and you may not be able to get an appointment at a short notice. It is very important to have a new patient appointment before you go for in-patient detox … in fact you may not need inpatient detox at all; your doctor may have an outpatient induction program.
You can not get Suboxone from Emergency Room.
Substance abuse treatment facility locator:
Call 1-800-662-HELP (4357) run by samhsa.
This site will help you locate facilities nearby based on state, city, or zip code.
These facilities are more likely to accept insurance.
1. Methadone Clinics: Methadone clinics prescribe Methadone and may also prescribe Suboxone/Subutex. These clinics are very few, located only in bigger cities, and require daily visit when you begin treatment. Methadone can not be prescribed by physicians outside these programs for addiction treatment.
You can search for a Methadone clinic in your state from the SAMHSA Opioid Treatment Program Directory:
2. Residential programs: There are several residential programs, that can range from a week to several months of treatment. These programs have a very fast taper, if any, and rely on denial of access to drugs, and behavioral changes rather than medications. Many of these programs receive state funding. The cost is usually based on a sliding scale, related to income.
These are comprehensive programs, which may also provide job training, and being residential include food and lodging during treatment etc. Some also accept single parents, including their children, … if there is no one else to take care of them. Most state funded programs will not accept a patient who has already used up the benefit once. Charity run programs are more likely to accept a patient even if they have had a relapse and need treatment again.
Your best source of information will be your insurance plan, as each policy plan is different in its coverage. Preauthorization is always required.
Ask them for:
- a list of contracted addiction treatment providers in your network
- duration of treatment coverage
- medication coverage, for how long? and quantity limits?
- contracted providers are usually full … so expect to be placed on a waiting list
Even if you can not find a physician in your insurance network, you may be able to submit your physician’s bill/CMS 1500, and seek reimbursement from your insurance carrier, … call them and ask for the procedure. Most of them will find some excuse to decline it.
Some insurance plans contract out this coverage to companies like Magellan and ValueOptions. These companies generally do not cover for services provided by physicians who are not psychiatrists, or addiction specialists, and, or restrict coverage to approved Addiction treatment providers/facilities.
Call your insurance carrier and obtain a list of approved providers. If it is provided under your policy, and they can not provide you with the necessary treatment, then lodge a complaint, and demand that they reimburse your out-of pocket costs.
You can ask your insurance carrier to clarify their policy regarding Suboxone coverage, and enroll additional providers.
Most insurances, including Medicare and Tricare do not cover outpatient opioid addiction treatment.
- They only cover inpatient opioid addiction or detox treatment, generally limited to 3 days.
- Addiction treatment falls under behavioral health … see if your policy has such coverage. If it does then your insurance will cover it only if you go through their approved providers. They may cover inpatient residential rehab or outpatient treatment programs.
- Addiction treatment facilities and Addiction specialists are more likely to accept insurance.
- Doctors who accept insurance are also more likely to be full to their capacity.
- Some insurances including Medicare/Medicaid will cover your doctor visits if it is for a purpose other than addiction treatment. That is you have a dual diagnosis thus allowing the psychiatrist to bill for a different diagnosis.
- Your prescriptions are covered by your prescription plan which is different from your insurance plan. So sometimes your doctor visits are not covered but your prescription is covered.
- Most Suboxone providers are not addiction specialists, that is they do not have Fellowship training or Board certification in addiction medicine.
- Drug addiction treatment act does not require a doctor to be an addiction specialist.
Many PCP’s will accept insurance for other services but not for Suboxone because of re-imbursement problems. It is still worth while to obtain Suboxone from such providers as any associated problems, blood tests, etc, may be covered by your insurance.
Tenncare provides limited coverage only through approved providers. Call your insurance and ask for Substance abuse treatment or Addiction treatment.
Your prescriptions may be covered by your prescription plan … which may be different from your insurance plan. Ask them if Suboxone prescriptions are covered, which brand is covered, whether pre-authorization is required, quantity and duration limits if any, and the co-pay.
Whether insurance pays or not … paying for the outpatient treatment … doctor’s fee, counseling fee, medication costs, tests … will still be cheaper than buying illicit drugs.
This page was last modified on: April 22, 2020