Does Insurance Cover Medication-Assisted Therapy for Addiction?

Does Insurance Cover Medication-Assisted Therapy for Addiction?Some medications have been approved to successfully help treat addiction. Known as medication-assisted therapy, this treatment is primarily used for opioid dependency, including addictions to heroin, morphine and prescription drugs. The Substance Abuse and Mental Health Services Administration (SAMHSA) certifies programs that provide methadone and other drugs used to treat addictions.

SAMHSA supports the use of medication along with counseling and behavioral therapy as an effective way to treat addiction to opioids.

How Does Medication-Assisted Therapy Treat Addictions?

Since the 1960s, physicians have used methadone to wean addicted patients off heroin or other opiates. Methadone and buprenorphine can alleviate an individual’s physical symptoms of withdrawal and help block the emotional need to take illegal drugs by affecting receptors in the brain.

Drugs used to treat opioid addictions work in a variety of ways, according to SAMHSA. Some of the drugs used by medical professionals to alleviate opioid addictions include the following:

  • Methadone – This drug can help prevent withdrawal symptoms but may produce similar effects to opioids. When used in conjunction with counseling, it can be an effective part of therapy.
  • Buprenorphine (Subutex) – This drug may be used to treat withdrawal symptoms, but may still produce a less intense high.
  • Buprenorphine-Naloxone Combination (Suboxone) – This drug is a combination of buprenorphine, which creates a lesser high, and naloxone, which works to block the effects of the opioid, and may be effective for some patients.

Health Insurers and Medication-Assisted Therapy

Medication-assisted therapy for addiction is widely available and is approved by the U.S. Food and Drug Administration. Since the treatment is prescribed by physicians, a health insurer’s behavioral health plan may cover part or all of the treatment cost.

Behavioral health insurance benefits vary widely by state and by plan. Individuals should call their provider for prior authorization to approve treatment and find out specific coverage levels. There will also likely be different co-pay and coinsurance figures for inpatient hospital stays that require medication-assisted therapy, compared to outpatient treatment services that include methadone dispensing.

Addictions Treated by Medication-Assisted Therapy

While opioid addiction is the most common type of addiction treated by medications, there are also drugs available that are approved to treat tobacco and alcohol addictions, such as the following:

  • Nicotine replacement therapies – This class of drug includes the brand names Nicorette, NicoDerm and Commit.
  • Bupropion – This drug helps to lower the intensity of nicotine cravings and withdrawal symptoms and may be known by the brand names Zyban andWellbutrin.
  • Varenicline – This drug works to block pleasure receptors in the brain associated with nicotine and may be known by the brand name Chantix.
  • Naltrexone – These drugs, such as ReVia and Depade, can lower one’s cravings for alcohol and blocks the effects of opioids.
  • Disulfiram – This drug can help prevent relapse to alcohol addiction and is commonly known by the brand name Antabuse. It works by creating unpleasant effects when small amounts of alcohol are consumed.
  • Acamprosate – This type of drug, often known by the brand name Campral, can help heal the brain functioning of those who drink large amounts of alcohol.

Need Help Finding Medication-Assisted Therapy for Addiction?

If you or a loved one is suffering from an addiction and needs medication-assisted therapy, please call our toll-free helpline. Our counselors are available 24 hours a day, seven days a week to help answer your questions about addiction and help you find the steps toward recovery. Do not let an addiction stand in the way of a better life.