aetna suboxone

Aetna Suboxone Coverage

Navigating through an Aetna insurance policy to see if it will pay for Suboxone treatment can be very time consuming. Not to mention, if done incorrectly it could cost you hundreds of dollars a month. Call us today to speak with a policy expert who can check your specific coverage to find out if your treatment will be paid for in full.

What is Suboxone Used For?

For those with addictions to opioid painkillers, treatment can be difficult, with relapse waiting just around the corner. More than two million people in the USA are addicted to drugs like OxyContin, Vicodin, Codeine, Fentanyl, and Percocet. This is four times as many people are addicted to heroin. People rarely start out with a plan to get addicted to prescription pain killers.

What happens is that they get a prescription after surgery or for something as normal as persistent back pains or arthritis. The opioid medication does help mask their pain, but the other effect of opioids is to give a sense of power and a sense of euphoria. And, for some people, this becomes the reason to take the drug. Over time, the body gets used to the drug and higher and more frequent amounts are needed to obtain the same feeling. This “tolerance” is a defining part of drug addiction and it leads to progressively more drug-seeking behaviors such as doctor shopping for prescriptions at several clinics in order to maintain enough drugs to support the addiction.

But, it turns out that there is one opioid medication that actually helps people with opioid addiction. Suboxone is used for opioid withdrawal and as a part of a drug rehab regime to treat drug addiction. But, medications cost money. Does Aetna cover Suboxone? Let us look at how addiction works and then whether or not Aetna covers Suboxone.

Chemical messengers called endorphins are basic to developing opioid addiction and treating it. When a person takes an opioid painkiller the endorphins are turned on in the brain. The result is the masking of pain and a sense of happiness and power. Both effects are temporary. So, in order to get pain relief again the person takes pill after pill. And, time and again, he or she experiences the resulting “high.”

Sooner or later, depending on the person, the happy feeling becomes more important than getting pain relief. In fact, the reason for the initial pain may be gone. But, the drug addict will continue to use the drug anyway. Suboxone is also an opioid, but it does not produce the degree of euphoria and strength that the addictive painkillers do. Thus, Suboxone is used to help ease withdrawal from opioids and for longer term treatment. Over the longer term, Suboxone helps protect the recovering drug addict from cravings and relapse as he or she enters into a new and drug-free life. A year of Suboxone treatment in gradually decreasing dosages is common for recovering drug addicts.

Suboxone is always used as part of an integrated twelve step drug rehab program

And, does Aetna cover Suboxone? Yes, they do. The amount they contribute to paying for Suboxone will vary according to the specific insurance policy or plan that the person has. There are commonly co-payments for each prescription. And, the person’s policy may have a deductible that needs to be exceeded before they pay for anything. And, because this drug is used to treat drug addiction, it will be prescribed by an Aetna-affiliated doctor who will want to keep a close tab on its use.