Does Blue Cross Blue Shield Cover Sublocade? Cost Without Insurance

Does Blue Cross Blue Shield cover Sublocade? Blue Cross Blue Shield (BCBS) covers addiction treatment costs, including medicines for substance abuse. However, its coverage for Sublocade varies from one state to another. Read on to learn the BCBS policies for Sublocade in New Jersey. 

Sublocade can help you control opioid urges. ChoicePoint accepts Blue Cross Blue Shield alcohol and drug treatment; doctors are licensed to prescribe and administer Sublocade. Get in touch with us today 844.445.2565. 

CALL NOW FOR FREE SCREENING

Sublocade Benefits For Opioid Addiction 

Sublocade is a prescription injection used to treat opioid use disorder (OUD). Unlike Suboxone, Sublocade consists of buprenorphine, which is a partial opioid agonist. It binds to the same site in the brain where opioids bind (opioid receptors). Sublocade does produce euphoria but is less intense than that of morphine and other opioids. Sublocade is used during detox to help: 

• Curb opioid urges
• Decrease the intensity of opioids
• Maintain abstinence

The Cost Of Sublocade Without Insurance

Sublocade, the buprenorphine injection, is administered once a month. Sublocade’s cost is much higher than Suboxone, which is a daily medicine prescribed for opioid addiction treatment. The amount of Sublocade might differ from one state to another, but it wouldn’t be wrong to say that Sublocade injection will cost you more than 1000$. In addition, you need a licensed Sublocade doctor near you to administer Sublocade injections under the skin, which means you also need to pay the physician. 

Sublocade Cost With Insurance

Sublocade is indeed a costly medication, taking into account the physician’s fee and the medication’s charges. But with insurance, Sublocade charges for you can be as low as $407 depending on whether: 

• You have Medicaid, Blue Cross/ Blue Shield, Medicare
• Your state of residence
• Your insurance plan 

Blue Cross Blue Shield Insurance for Addiction Treatment

Does Blue Cross Blue Shield Cover Sublocade?

Fortunately, Blue Cross/Blue Shield does provide Sublocade coverage. However, Blue Cross/Blue Shield’s drug rehab policies differ for each state. Depending on your state and BCBS insurance plan, it may or may not cover Sublocade for you.

Blue Cross Blue Shield Coverage For Sublocade In New Jersey

Blue Cross Blue Shield is branded as Horizon Blue Cross Blue Shield (HBCBS NJ). If you are based in New Jersey, there is good news. Horizon NJ Blue Cross Blue Shield addiction treatment will cover your cost for Sublocade, but prior authorization is required. Here are the pointers to help you qualify for Sublocade insurance:

• Opioid addiction is severe
• Suboxone or other medications are not suitable for you
• You are enrolled in addiction therapy 

It can take some time for authorization, but all the wait will be worth it in accessing Sublocade and managing your withdrawal symptoms. 

Who Can Prescribe Sublocade Near You In New Jersey?

Only authorized Sublocade doctors can prescribe Sublocade in New Jersey and the rest of the United States. Sublocade comes with a black box warning from the Food & Drug Administration (FDA), the most serious warning. This label cautions about administering the Sublocade under the skin and not in the veins. This mishap can result in blood clots leading to death if not followed by prompt action. Addiction medicine doctors who meet the following criteria can prescribe Sublocade:

1. Are officially trained for administering Sublocade injection
2. Acquire Sublocade via the REMS Program
3. Have a registration number from the Drug Enforcement Administration 

Sublocade Doctors Who Accept Blue Cross Blue Shield

The addiction treatment centers (such as ChociePoint in New Jersey) provide insurance-covered treatments. With the mission to make treatment accessible, ChociePoint accepts Blue Cross Blue Shield and other commercial & government insurance. You can verify your insurance online. 

Following ASAM criteria, we provide all continuum of care. It means you can have coverage for the following Blue Cross Blue Shield drug rehab:

• Inpatient Treatment
• Painless and Rapid Detox
• Outpatient Program
• Intensive Outpatient Program
• Addiction Therapies
• Aftercare, including support groups 

Although we accept BCBS coverage, the number of services you can get through your insurance will depend on your specific plan. Blue Cross/Blue Shield might cover an inpatient treatment program for people with a higher insurance plan, but those with a lower plan might only have medications covered. 

ChoicePoint Offers Insurance-covered online OUD (Opioid Use Disorder) Treatment. Avail Today!

We live in a fast-paced world, and taking time for regular hospital visits is difficult. But this should not be the reason to opt out of your chances of achieving sobriety. ChoicePoint offers telehealth services so you can recover from home. It will provide you with the following services:

• Online Appointments
• Addiction therapies
• Prescriptions
• Follow-ups 

With our simple admission process, you can receive online prescriptions and addiction therapies, so start your opioid treatment today. Our addiction professionals can prescribe and administer you Sublocade and other medications you need to eliminate opioids from your body and hop on the road to recovery. Get in touch with us today 844.445.2565.

Help Section Answering Questions About Blue Cross Blue Shield Rehabilitation Coverage

Here are a few answers that can help you better understand BCBS drug rehab and policies for acquiring Sublocade under insurance: 

Does Medicaid Cover Sublocade?

Sublocade is generally not preferred for insurance coverage because it is not as widely prescribed as Suboxone. However, as with Medicaid policies, sublocade coverage will vary from one pharmacy to another. Some states do allow Medicaid coverage for Sublocade, while others may not. If Medicaid covers Sublocade for you, then you’re in luck, as it might cost you only $1$—$4$ on average. 

Is Sublocade Better Than Suboxone?

It’s a tricky question to answer as everybody and their requirements are different. Sublocade might be best for you but not for your friend. It is important to work with an addiction medicine specialist to know what medication can help you overcome opioid use disorder. Generally, people prefer Sublocade over Suboxone to avoid the hassle of taking a daily tablet or are sensitive to Suboxone’s Naloxone. 

How Do You Qualify For Sublocade?

You are eligible for a Sublocade prescription and injection if you meet the following criteria:

• Age above 18 years
• Diagnosed with moderate to severe OUD
• Have taken sublingual buprenorphine (Suboxone) for 7 days
• You are in the detox phase of opioid treatment

Sublocade is an expensive treatment option. Check with your insurance provider to know how does Blue Cross Blue Shield cover Sublocade for you.

What Does Sublocade WithDrawal Feel Like?

Although Sublocade doctors carefully monitor you when you quit using Sublcoade, it’s natural to experience a few withdrawal symptoms. However, if you are under supervision, then your withdrawal will not be intense. You can experience the following symptoms: 

• Body pain
• Insomnia
• Diarrhea and vomiting
• Extreme fatigued
• Anxiety

 But quitting Sublcoade cold turkey can make these symptoms severe. 

Can I Get Sublocade From A Nearby Pharmacy?

You cannot purchase Sublocade from just any drugstore. Pharmacies need to have a Sublocade license (REMS program) before they are eligible to provide Sublocade injections to their customers. If your nearby pharmacy has the appropriate license,you can surely get Sublocade from them. Otherwise, reach out to your addiction physician to administer the injection.

What Insurance Cover Sublocade? 

Depending on your insurance policies and state of residence, the following insurance providers cover the partial or complete cost of Sublocade injection:

• Medicaid
• Blue Cross Blue Shield
• Medicare
• Cigna

What Pharmacies Accept Horizon NJ Health?

Interestingly, most retail pharmacies accept Horizon NJ Health. This means you can obtain most prescription medications without paying any or most of the cost out-of-pocket. If you are still confused about certain medications, such as Sublocade or Vivitrol, call your insurance provider to find out what amount you will have to pay with insurance. 

Reference

1. National Center For Biotechnology Information. 2024. Physiology, Opioid Receptor
   https://www.ncbi.nlm.nih.gov/books/NBK546642/
2. The Journal of Allergy and Clinical Immunology. “Black box” 101: How the Food and Drug Administration evaluates, communicates, and manages drug benefit/risk
   https://jacionline.org/article/S0091-6749(05)02325-0/fulltext
3. National Center For Biotechnology Information. 2019. Clinical Review Report: Buprenorphine extended-release injection (Sublocade)
   https://www.ncbi.nlm.nih.gov/books/NBK546461/
4. Sublocade. What is the SUBLOCADE® REMS
   https://www.sublocaderems.com/
5. American Society of Addiction Medicine. About The ASAM Criteria
   https://www.asam.org/asam-criteria/about-the-asam-criteria