When I screamed to my doctors and my insurance company substance abuse line for help to get off opiates, no one helped med. I went to the ER, doctors appointments and my isurance company psychiatry department and called the insurance company substance abuse line more times than I could count. The hotline clinition even suggested I go the ER and say I was going to commit suicide because I could not get anyone to help me. I finally took my recovery into my own hands. I found a doctor who would help me. At the consultation visit he said that the medication needed to help me was expensive and my insurance company would not cover it. But that I would file claim with my insurance and i would be denied. But that in filing an appeal I would be reimbursed. That it was the LAW. While I trust my doctor, I am still nervous about it. I have been on the medication for 1 1/2 years because I do have pain, which is where the addiction began. I have spent close to $11,000.00 on this medication. If youhave any knowledge regarding a situation such as mine, I would greatly appreciate it. Just so my mind can be put at ease while I am going through the appeal process.
No insurance out there will cover every prescription on the market. If they don't cover it, they don't cover it. I think it's ridiculous that most all insurances will cover oxy, fentynal, hydro, etc but won't many don't cover suboxone or subutex. Sounds like your sub doctor might have fibbed to you.
All I can recommend is to get a list of all the medications your insurance does cover and see if it is on the list or has ever been on the list.
I know the frustration you feel. I too have to pay cash as mine doesn't cover it either. They do cover my office visit though. Go figure.
Maybe the laws vary from state to state so my situation may be different than yours so try not to worry.
Best of luck to you.
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