Does Insurance Cover Suboxone Medication?
Yes — depending on your prescription drug coverage.
Many health plans provide coverage for medications used to treat opioid use disorder. However, your actual out-of-pocket cost depends on your individual pharmacy benefit, formulary, deductible, copay or coinsurance, pharmacy network, and whether the plan has additional coverage requirements.
The FDA recognizes buprenorphine as one of three FDA-approved medications for opioid use disorder and lists Suboxone as well as generic buprenorphine/naloxone tablets and films among available buprenorphine products.
What If Acorn TeleMAT Does Not Accept My Insurance? Can My Medication Still Be Covered?
Yes — potentially.
Your medical visit benefit and prescription drug benefit are not necessarily the same thing. This means that even if you self-pay for your visit with Acorn TeleMAT, your pharmacy may still be able to process your buprenorphine/naloxone prescription through your prescription insurance.
Self-pay for the visit does not automatically mean self-pay for the medication.
Does Medi-Cal Cover Buprenorphine/Naloxone?
Yes — buprenorphine products used for opioid use disorder are included in the Medi-Cal Rx drug benefit, subject to applicable coverage rules.
California's current Medi-Cal Rx Contract Drugs List specifically includes utilization rules for buprenorphine products indicated for opioid use disorder. Medi-Cal Rx also provides a drug-lookup system where members and providers can check current coverage requirements.
For eligible Medi-Cal patients, out-of-pocket medication costs may be very low or $0 in many circumstances. However, coverage should be verified for the specific prescription rather than assuming that every formulation or pharmacy claim will be covered.
Check Medi-Cal Rx drug coverage →
Does Suboxone Have One Set Price?
No. There is no single pharmacy price that applies to every patient. Your cost can change depending on:
- Your insurance plan
- Brand-name vs. generic medication
- Tablets vs. films
- Dose
- Quantity prescribed
- Pharmacy
- Pharmacy network
- Available prescription discounts
Generic buprenorphine/naloxone products are FDA-approved options for opioid use disorder. Because pharmacy prices and insurance benefits can change, it is better to compare the current price than rely on one advertised number.
Can I Pay Cash for Suboxone?
Yes. If you are not using insurance for the prescription, you can ask the pharmacy for its cash price. The same prescription can have different prices at different pharmacies, so it can be useful to compare pharmacies before filling your medication.
Is GoodRx Free?
Yes. GoodRx provides prescription pricing information and free discount coupons. GoodRx discounts are not health insurance. You can check participating pharmacy prices before filling your prescription.
Check current prices on GoodRx →
Can GoodRx Lower My Suboxone Cost?
Yes — sometimes.
A GoodRx discount may provide a lower cash price for generic buprenorphine/naloxone than the pharmacy's regular cash price. In some situations, the discounted price may also be lower than a patient's insurance copay.
The actual price depends on the medication, strength, quantity, participating pharmacy, and current discount. Because buprenorphine is a controlled medication, GoodRx also notes that acceptance of its discount for controlled medications is subject to the pharmacist's discretion.
Watch: Suboxone for $26 a Month? Here's How
This short video explains how prescription discounts may help some patients reduce their medication cost.
▶ Watch on YouTubeImportant: the price shown in the video is an example, not a guaranteed price. Medication prices can change by pharmacy, dose, quantity, location, and available discount.
Can I Use GoodRx If I Have Insurance?
Yes. You may choose to use a GoodRx discount instead of your prescription insurance if the GoodRx price is lower.
However, GoodRx cannot be combined with insurance for the same prescription purchase. GoodRx also states that its discounts cannot be combined with Medicare or Medicaid benefits.
In other words, compare: insurance price → cash price → GoodRx price. Then ask the pharmacy which available option provides the best price for you.
Can I Use GoodRx With Medi-Cal?
Not together. GoodRx states that its discounts cannot be combined with Medicaid, which includes Medi-Cal in California.
If Medi-Cal covers your prescription, you would generally use your Medi-Cal Rx benefit. If you are considering paying outside of Medi-Cal using a discount, discuss your options with the pharmacy first.
Can Different Pharmacies Charge Different Prices?
Yes. Your out-of-pocket price can differ between pharmacies, particularly when you are paying cash or using a prescription discount. That is why checking the price before your prescription is filled can be useful.
What Is the Best Way to Lower My Suboxone Cost?
Start by comparing your available options:
- Check your insurance pharmacy benefit. Ask what your copay will be for the prescribed medication.
- If you have Medi-Cal, check Medi-Cal Rx. Coverage and requirements can be checked through California's Medi-Cal Rx resources.
- Ask the pharmacy for the cash price.
- Check a free prescription discount service such as GoodRx.
- Compare pharmacies. The lowest available price may not always be at the pharmacy you normally use.
Frequently Asked Questions
If I pay cash for my Acorn TeleMAT visit, can I still use insurance for my medication?
Yes, potentially. Paying cash for your medical visit does not automatically prevent the pharmacy from processing your prescription through your prescription insurance. Your actual coverage depends on your plan.
Do I need insurance to use GoodRx?
No. GoodRx discounts can be used without health insurance. GoodRx is a prescription discount service, not insurance.
Is insurance always cheaper than GoodRx?
No. Depending on your plan and the current discount price, GoodRx may sometimes be less expensive than your insurance copay. Compare both before paying. GoodRx cannot be combined with insurance for the same purchase.
Is generic buprenorphine/naloxone the same as Suboxone?
Suboxone is a brand-name buprenorphine/naloxone product. FDA-approved generic buprenorphine/naloxone products are also available for opioid use disorder.
Can Acorn TeleMAT guarantee what my medication will cost?
No. Medication prices and insurance benefits are determined by the pharmacy, insurer, medication, quantity, and other coverage factors. Acorn TeleMAT cannot guarantee a specific pharmacy price or insurance copay.