Does Blue Cross Blue Shield Cover Subutex in NJ

Does Blue Cross Blue Shield cover Subutex doctors in NJ? Yes, BCBS covers Subutex (Buprenorphine), a brand-name medication. Depending on your plan, your plan may not cover brand-name Subutex medication, but it will cover its generic form (Buprenorphine Hydrochloride HCL).  

ChoicePoint is a premier drug rehab that accepts BCBS in NJ. You can get an online or in-person BCBS-covered Subutex prescription by calling 844.445.2565.

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Does Blue Cross Blue Shield Cover Subutex? Coverage Details 

Subutex is an FDA-approved medication for opioid addiction treatment. Blue Cross Blue Shield covers Subutex in all levels of care, including:

1. Inpatient Treatment 
2. Intensive Outpatient Program
3. Outpatient Program 
4. Telehealth/Online services 

However, Subutex is included in the list of medicines that require Medically Necessity Determination/ Prior Authorization. This means your doctor will fill in a form and initiate a request highlighting the need for Subutex in your treatment plan. The coverage also depends on:

Type of Insurance Plan

The new laws have bound insurance companies to cover the cost of opioid addiction treatment and medicines to some extent. The exact coverage depends on your specific plan.

How Much Does Subutex Cost With and Without Insurance?

A monthly supply of Subutex can cost around $200-400$ without insurance. While insurance covers most of the cost, there may be some out-of-pocket expenses depending on your outplan. There may be no pocket costs for some additional costs, depending on the following: 

1. Coinsurance and Copay Policies

Coinsurance is the percentage of the cost paid by the individual, while co-pay is a pre-set, exact cost that an individual pays. For example, if the price for a Subutex tablet is $300/ month and your co-pay is $50, then you pay $50, and the company pays the rest. 

2. Insurance Plan Tier

Blue Cross Blue Shield offers different tiers based on your affordability and medical needs, for example:

3. State Policy 

Your insurance policy is dependent on the state you live in. Some states have zero out-of-pocket costs and do not require prior authorization for Buprenorphine prescription. The best thing to do is to call your insurance provider or verify your insurance with BCBS in-network rehab such as ChoicePoint. 

Steps To Take If Your BCBS Plan Does Not Cover Subutex?

While BCBS provides excellent coverage for Subutex, if somehow your plan is not covering the cost, you can take the following steps:

1. Ask for coverage for generic Subutex, which is Buprenorphine 
2. Check if you are getting the prescription from BCBS in-network rehab
3. Check if your Subutex doctor is in-network with Blue Cross Blue Shield
4. Ask your doctor to provide a written confirmation that Subutex is medically necessary for your treatment. 

Our Blue Cross Blue Shield Subutex doctors in NJ can provide a same-day online prescription. Call 844.445.2565 to schedule an appointment. 

Same-day Subutex Prescription

Subutex is a Preferred Medication For Opioid Addiction Treatment, but Is It Effective? 

Now that you know that cost is not a worrying factor when getting Subutex, you might be wondering if this treatment is right for you. 

NIDA (National Institute on Drug Progress) and FDA have conducted several studies to establish the effectiveness of Subutex. It was approved in 2002 after extensive trials. Here are some studies that support the efficacy of Subutex.

1. A study investigated the effect of Buprenorphine on 326 Heroin subjects. The subjects were given Suboxone, Subutex, and a placebo group (no active treatment). After three weeks, urine drug tests were carried out. Subjects that received Buprenorphine showed statistically higher drug abstinence than the placebo group.
2. Another study examined the effects of Buprenorphine and counseling on subjects suffering from opioid addiction (aged 15-21). 50% of the individuals achieved successful results after 12 weeks. However, short-term use (1-3 months of Buprenorphine use) showed some relapse rates. Hence, long-term maintenance treatment and comprehensive care are recommended.

How To Get a Prescription From Online Subutex Doctors in New Jersey?

ChoicePoint is a premier addiction treatment rehab in Fair Lawn New Jersey that accepts Blue Cross Blue Shield. You can now get an online or on-site Subutex prescription by:

1. Call us at 844.445.2565 
2. Schedule an online appointment.
3. Insurance verification and request a call-back

List of Addiction Treatment Services Covered by ChoicePoint Blue Cross Blue Shield in NJ

Several studies show that Subutex is most effective when used alongside comprehensive opioid addiction treatment plans. If you are using Subutex, you might also consider these Blue Cross Blue Shield covered services by ChoicePoint:

Get Subutex Prescription From ChoicePoint! A BCBS-accepting MAT Clinic in NJ 

ChoicePoint is a CARF-certified Blue Cross Blue Shield addiction treatment in NJ. Here are the reasons to get a prescription for us:

1. Online and on-site prescriptions are available
2. We prescribe Subutex at all levels of care
3. Availability of evening treatments 
4. Availability of prescriptions and treatments on weekdays. 

Free Addiction Assessment

Please note this assessment is an initial self-screening, and it is not meant to be a medical assessment or clinical diagnosis of addiction. For proper diagnosis and treatment, schedule an appointment with ChoicePoint.

Frequently Asked Questions Related to Blue Cross Blue Shield Subutex Coverage in NJ

More of your questions are answered below:

What is Subutex Generic Medication?

Subutex is a brand name for opioid addiction treatment medicine. The generic name is Buprenorphine sublingual tablets. 

What Are Considered Tier 2 Drugs?

Prescription drugs are characterized into different groups known as tiers based on their cost. The tiers are as follows:

Which is Better, Buprenorphine or Suboxone?

Suboxone has buprenorphine as an active ingredient. Both Buprenorphine and Suboxone are the same. Suboxone has Naloxone, which is an additional ingredient that reduces the risk of abuse, which is not present in Buprenorphine. The best medicine for you is decided by your doctor. 

What Class is Buprenorphine Subutex?

Buprenorphine is a Schedule III drug. It is sold on prescription only. 

Sources 

1. NIDA.NIH.GOV | National Institute on Drug Abuse (NIDA). Retrieved November 11, 2024, from
   https://nida.nih.gov/
2. Drug Approval Package: Subutex (Buprenorphine HCI) Suboxone (Buprenorphine HCI & Naloxone HCI Dihydrate) NDA #020732 & 020733. (n.d.). accessdata.fda.gov. Retrieved November 11, 2024, from https://www.accessdata.fda.gov/drugsatfda_docs/nda/2002/20-732_20-733_subutex.cfm
3. Horizon BCBSNJ Health Plans – BlueCard® PPO. (n.d.). Horizon Blue Cross Blue Shield of New Jersey. Retrieved November 11, 2024, from https://www.horizonblue.com/members/plans/medical-plans/bluecard-ppo
4. Horizon BCBSNJ HMO Plan & Services. (n.d.). Horizon Blue Cross Blue Shield of New Jersey. Retrieved November 11, 2024, from https://www.horizonblue.com/members/plans/medical-plans/horizon-hmo
5. Horizon EPO (Exclusive Provider Organization). (n.d.). Horizon Blue Cross Blue Shield of New Jersey. Retrieved November 11, 2024, from https://www.horizonblue.com/employers/plans-services/medical-plans/group-medical-plans/small-employer-medical-plans-2-50-employees/horizon-epo-exclusive-provider-organization
6. Reference ID: 4215177. (n.d.). accessdata.fda.gov. Retrieved November 11, 2024, from https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020732s018lbl.pdf