My Insurance Co Refuses To Pay For Subutex Though My Dr Has Complied 100% With The Requirements Prove That I Meet All Criteria

Sharky James Says:

I am an addict who has successfully utilized Suboxone & Subutex as a means to keep a handle on my addiction. Medicare assigned HUMANA to me as my primary care insurance co Humana has denied payment for my prescription, claiming it is not formulatory. I appealed this decision & was denied M Dr.s. office has provided all documentation required them, proof that I attend substance abuse classes, I take periodic UA's and am in fact following through with all requirements, but I am STILL being denied!!! Please!, what can I do?

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David Says:

Hi Sharky,

Sorry to hear about your situation with the insurance company not wanting to budge. From my experience these types of companies can often be very difficult to work with, especially at times when you may need them most! It sounds to me like your best bet would probably be to look into different insurance companies who do cover Subutex. That, or potentially utilizing drug savings cards such as the one MedsChat offers here, to help offset its cost every month: RX Savings Card

You may actually be surprised at how much you're able to save using one of these cards. 15-75% off is a nice alternative in my opinion.

I hope this helps and wish you good luck in sorting out the situation with Humana!

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Sharky James Says:

I went to the pharmacy and the Insurance went through, even though I had received another letter of denial !! So, total cost for #60 , 8 mg Subutext was $1.20. There are lights at the end of these tunnels!

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golden Says:

You need to ask the insurance company for a complaint to fight why they will not pay never give up they hang around and have a quota to make with refusals do not let you be one of them I am so sick of working most of y life as a nurse then be so disrespected from these medical professionals over seeing a Drs. care. Let them work a small time in a situation like burn unit and go home and cry for some of these patients. It is legally and ethically that patients be treated and given proper care. Sometimes this is needed with narcotics. In your case another. Please do not let big companies have the last say over good Drs.

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Comments Says:

Re: David (# 1) Expand Referenced Message

Just wondering if your state has a Department of Insurance. Illinois has one and I have contacted them for other types of insurance, but not sure if they would even attempt to assist on this type of complaint. My mind goes to lawmakers. It is election time...this is a very important subject matter to many people and with all the hoopla on opiate abuse, I would make as much stink as I could, writing Washington if I had to. Contact Good Morning America and all the documentary folks. I would raise hll if it were me. Just saying, the people that are in charge are taking way to effing much on themselves and treating us like poopla, give it back to them. It will take time unfortunately, but raise it and in the meantime, go to a Mental Health clinic and ask if they can help you. Do you have a County Health Department in your state? Try that. Go to newspaper and talk to a reporter asking if they will help you get the word out that Humana is doing this to people. Beyond stupid of them....beyond ignorant. I am so sorry for you. Good luck in your journey for right from wrong.

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