Medicaid Cracking Down On Paying For Suboxone?

I'm not sure how many are aware of all the new changes Medicaid has and continues to change against suboxone, not good! At one time medicaid paid for suboxone with PA without all the restrictions. After adding many restrictions causing many doctors to stop doing PA meaning you paid our of pocket for your meds even though you have 100% medicaid. Then as of April 1st 2017 the ARTS Program started that claimed anyone who had medicaid shouldn't be paying out of pocket for their meds. Also they claimed there would be many doctors taking medicaid for the office visit,well that was a lie and the few who do really put you through the ringer. I was told I would receive reimbursement from my insurance for the off call and meds by filing a appeal under the ARTS program and send all receipts with it. Well believe either or not yes I got my first reimbursement and was told I would continue to get this until the new change in November.

Well, after sending in my 2nd receipts for the appeal suddenly the story changed and I was denied for reimbursement on my meds but approved for office called and that will stop come November. Well I won't stop fighting for this because the ARTS program was designed for this very reason. Now here's the big bad change starting in November. Medicaid will no longer pay or reimbursement for suboxone unless your seeing one of the few providers who accept medicaid for office call even with a PA they won't pay. Well I have 2 in my area being withing 6 hrs distance and both have a very strict policy. You go 3 times a week to see the doctor,2 meeting a week and also you must be in a group outside of the clinic. They slowly work you up to once a week until you get to once every 2 wks but all groups stay the same. Now who us able to travel and do all of this,not many I'm it I'm guess that's what medicaid was hoping for so they save money. We'll it's how their out to hurt everyone who's on suboxone and I think we all need to stand up and fight back against them. No it may not change he right away but I do believe it will make a difference in time. I know I can't afford over $700 a month and I'm disabled and not able to go 3 times a week moreless travel and afford the gas n wearing my car out on top of it. I hope to see many others ready to fight back so we can start finding the right way to get medicaid attention and the government. I think their putting our life at risk,harming our health,and trying to destroy the life we worked hard to have. I plan on talking to a lawyer seeing what right we have and go from there. I think starting a social media about this would be a great place to start. How many are willing to do this.

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REPORT

I am very sorry about the issues you're experiencing, sadly, things may only get worse if some of the new cuts and changes to health care coverage get passed.

Is anyone else also dealing with such issues?

The FDA warns that Suboxone carries the risk of being habit forming and may cause side effects, such as nausea, dizziness, headache, constipation, and dry mouth.

What are you social media plans?

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Many won't know about this until after it takes effect in November because medicaid keeps it quite leaving you hanging because they don't care. I see all over the newsfeeds on Facebook about the opioid crisis and how badly people need help. Well sadly our government and Va medicaid feel different by putting all the new restrictions on suboxone user constantly. They think they can treat everyone's recovery the same but that's not so and they're aware of this but it's all about saving money instead of lives. Because some abuse suboxone they're punishing all of us and that's wrong. Why did they start the ARTS program claiming it was designed to give more people help paying for substance abuse recovery. Then turn it into a big joke making it were very few good even do this and for the ones who can't they will no longer get help with their meds. I don't understand why Va suddenly started coming down hard on people who are only trying to better their health and life. I hope many see this and contact va medicaid right away instead of waiting till November to find out their meds are no longer covered with a PA. I think people have waited too long sitting back while our Healthcare has been destroyed to the point now the government thinks they can continue since nobody will speak out. Well I know a couple of doctors and patients who are getting ready to start social media about how suboxone has changed their life's and how va medicaid and the government are now trying to destroy what many have worked very hard for. How many lives will be lost after medicaid stops paying completely for suboxone. Why is suboxone on the streets so bad now after medicaid and tenn care started all the restrictions and limiting how many they would pay for. Then throw in all the new laws va and tn started on top of this leaving many no choice to do whatever they had to just to afford their office call and price of meds too. Why don't they get on the companies for charging such a high price for the meds and doctors charging 400 a month making it where people could afford this on their own. What good is medicaid if it doesn't cover your meds or doctors. Why are they so hard on suboxone and subutex while making it easy to get help with methadone that many have overdosed on? Why can't they just help people who are doing right instead of destroying their life? Again please contact VA medicaid and ask them about how the new changes coming in November will affect you and make sure you ask about suboxone no longer being covered even with a PA unless you're seeing a doctor in the network who takes medicaid for the office call because that's exactly what they're planning on doing. Had they gotten their way this would've happened in July but they had to wait until they had enough doctors on board before passing this.

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I am on Suboxone and Medicaid so I would be willing to.

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I have been on Suboxone for chronic pain for about 3 years. I've have Humana for my Insurance as a PartD for my SSDRI. They started out covering most of the medicine except $8.35 with a PA but I got a letter last week that they aren't going to cover it any longer as of January 2018. So now I am going to go back to where I started... laying in bed day is day out in severe pain. May God bless each one of you that are having to fight addiction or those of us who use it for pain.

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Re: Katbird101 (# 4)

Medicaid now covers all buprenorphine without a PA starting dec 1 2017.

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Re: Staci (# 3)

Medicaid has always covered my buprenorphine/ naloxone. As of Dec 1 medicaid covers all buprenorphine without a PA. PAs are no longer needed no matter who is prescribing. I just switched drs I pay cash for my office visit and this month i was given buprenorphine. And my Medicaid still covered it.

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