Does Louisiana Medicaid pay for Suboxone treatment?
Yes. Louisiana Medicaid covers buprenorphine/naloxone, the medication sold under the brand name Suboxone, for opioid use disorder. The exact medication or form your plan covers without extra approval can vary. Louisiana's current Preferred Drug List includes preferred generic buprenorphine/naloxone options, while brand-name Suboxone may require prior authorization, or approval from Medicaid before it is covered.
Your healthcare provider and pharmacy can help you find the covered option that is right for you.
What is Suboxone and how does it treat opioid use disorder?
Suboxone is a medication used to treat opioid use disorder. It combines two medicines:
Buprenorphine helps reduce opioid cravings and withdrawal symptoms.
Naloxone is added to help discourage misuse of the medication.
Together, these medicines can help a person feel more stable while recovering from opioid use. Buprenorphine is one of three main medications approved to treat opioid use disorder.
Taking medication for opioid use disorder is a form of medical treatment. It is not simply replacing one drug with another. The Substance Abuse and Mental Health Services Administration (SAMHSA) lists medications for opioid use disorder as evidence-based treatment options. Treatment can also include counseling, mental health care, primary care, and other support based on what each person needs.
What opioid use disorder medications does Louisiana Medicaid cover?
Louisiana Medicaid covers several types of medication used to treat opioid use disorder. Options may include:
Buprenorphine/naloxone, including generic versions of Suboxone
Buprenorphine, which reduces cravings and withdrawal
Naltrexone, available in different forms and used to block the effects of opioids
Methadone, which reduces cravings and withdrawal and is provided for opioid use disorder through approved opioid treatment programs
Different medications work better for different people. A healthcare provider can help you decide which option is safest and best for you.
Some medications or brand-name versions may need approval from Medicaid before they are covered. Your provider or pharmacist can check the current Louisiana Medicaid Preferred Drug List for you.
If you are looking for substance use treatment outside of Nest, you can also use FindTreatment.gov to search for treatment providers.
Can I get Suboxone through telehealth with Louisiana Medicaid?
Some Suboxone care can happen through telehealth, but Louisiana has rules about prescribing controlled medications such as buprenorphine. For physicians prescribing controlled substances through telemedicine, Louisiana generally requires at least one in-person visit with the patient within the past year, unless an exception applies.
After an appropriate in-person visit, some follow-up care may be able to happen virtually when it is medically appropriate. A provider may also ask to see you in person if a physical exam or other hands-on care is needed.
Federal telehealth rules can also affect how controlled medications are prescribed. Because these rules can change, ask your healthcare provider what is required for your situation.
You do not have to navigate opioid use disorder treatment alone. Nest Health provides compassionate, judgment-free substance use treatment as part of whole-family healthcare for eligible Louisiana families. Nest's program includes medication treatment such as buprenorphine/naloxone when appropriate, along with primary care, mental health support, and help coordinating care. Nest is available through select Medicaid health plans, and not every member is eligible. Call 866-222-NEST (6378) to find out whether Nest's services are available to you or your family.
