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I recently switched Suboxone doctors and had my first appt today, The Doctor assumed I was on state Medicaid (until she looked how I was paying), she told me KY Medicaid/ Medicare will ONLY pay for brand name Suboxone, (they will not cover the much cheaper generic)...
After she saw I had other health insurance, she said she had a feeling if many tax paying citizens in the state, knew they were paying for Suboxone for people addicted to Heroin, they would likely be pretty mad! (I think she is right on that!)
There is no limit on quantities or how long someone can be on it either.
This is not exactly nickles and dimes difference either....a 30 day supply for someone taking 8mg dose of the brand name Suboxone is over $700. the generic 8mg films cost around $80 for a 30 day supply!!
I could not believe this absolute waste of tax payer money! (and its been this way since Obamas term)
**I think I now understand why none of the pharmaceutical companies tried to challenge the Govts crackdown on prescription painkillers!!! They knew LOTS of people would need Suboxone treatment for many many years. I need to buy stock in pharma companies.
Because of the large role of rebates in reducing Medicaid drug costs, the drug with the lowest price is not always the drug that costs the least. Because generic drugs are usually lower-cost but still therapeutically equivalent to brand name drugs, most state Medicaid programs require generic substitution unless the prescriber specifies that the brand is medically necessary. However, there are some instances where, due to the structure of the rebate program, the generic drug is not the lowest cost drug to the program.
States are increasingly comparing the net cost of the brand drug to the net cost of the generic drug to make sure that the state is paying the lowest price, also known as “brand-over-generic” programs.26 Estimates suggest these programs can lead to substantial savings. This is especially the case at the initial entrance of a generic equivalent into the market, when a state may still have supplemental rebate agreements and other large rebates that offset the price of the brand drug. New York is one state with a specific program that promotes the use of brand-name drugs over generics whenever the brand name drug is less expensive to the program. As of the release of this brief, there are 30 drugs on the program list.27
I asked because on the STATE's website it list the generic as Medicaid approved. Guess Doctors and Pharmacist know more than the State.
that is pretty strange then, the pharmacist told me Medicaid only covers the brand name.
I will find out for sure, the next time our group meets, I will ask the other patients, nearly every other patient in my group is on medicaid, 2 ladies are on Medicare.
that is pretty strange then, the pharmacist told me Medicaid only covers the brand name.
I will find out for sure, the next time our group meets, I will ask the other patients, nearly every other patient in my group is on medicaid, 2 ladies are on Medicare.
Does your state use managed care medicaid? The benefits can vary based on plans. For example, where I live now, people can sign up for county care plans or plans through private insurers that are still Medicaid plans. However, the people on County Care typically have to use facilities within the county system while people on private plans typically go to other clinics.
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