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How much does naltrexone cost? With + without insurance

For many people managing opioid use disorder (OUD), one of the biggest worries about starting a new medication like naltrexone is whether they can actually afford it. This is especially true for individuals who have been blindsided by surprise bills or unclear pricing in the past.

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If you’re weighing different medication options, pricing often shapes what feels realistic. That’s why we’re breaking down how much different forms of naltrexone cost with and without insurance. Learn how to reduce your out‑of‑pocket expenses, what to expect from Medicaid and Medicare coverage, and how naltrexone’s pricing compares to other OUD medications.

Naltrexone cost at a glance

Naltrexone is available in three main formulations:

• Generic naltrexone tablet
• Extended‑release injection (Vivitrol)
• Compounded low‑dose naltrexone (LDN)

Here’s how pricing compares:

Cost of naltrexone without insurance

If you’re uninsured, the cost of naltrexone depends heavily on the formulation you choose. Both the generic oral tablet and the extended-release injectable (Vivitrol) are commonly used in medication-assisted treatment (MAT) and approved by the Food and Drug Administration (FDA) for OUD. 

Low-dose naltrexone is used off-label for conditions like autoimmune disorders and chronic pain. It is not FDA-approved.

Generic naltrexone pricing

Daily tablets of generic naltrexone (commonly prescribed in doses of 25, 50, or 100 mg) are significantly more affordable than Vivitrol without insurance. Most uninsured individuals pay $25–$108 for a 30-day supply.

Vivitrol pricing

Vivitrol, the brand-name monthly injection, is a different story in terms of cost. It typically runs about $1,176.50 per month without insurance—a price that’s unrealistic for most individuals paying out of pocket. Vivitrol’s manufacturer has granted Teva a license to produce a generic version of the extended-release injectable, but it will not launch until at least 2027.

Compounded low-dose naltrexone pricing

Low-dose naltrexone (LDN) is different from the standard doses of naltrexone used to treat OUD. LDN refers to very small doses (typically 0.1–4.5 mg per day) used off-label for conditions like autoimmune thyroid disorders, chronic pain, fibromyalgia, and multiple sclerosis. LDN is not FDA-approved for OUD care.

Because low-dose naltrexone is compounded (mixed by a specialty pharmacy to a non-standard dose), it is not covered by most insurance plans and typically requires out-of-pocket payment. The cost of LDN without insurance ranges from $20–$30 per month, depending on the compounding pharmacy.

If you're looking for OUD treatment specifically, learn how standard naltrexone works or consider whether buprenorphine-based care through Ophelia may be right for you.

What to keep in mind if you don’t have insurance

The same prescription can cost $25 at one pharmacy and $100 at another. Large chains, independent pharmacies, and grocery‑store pharmacies may all charge different rates for the same prescription, so be sure to shop around. Mail‑order pharmacies sometimes offer lower prices, but shipping fees may apply.

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Remember that the price of your medication is only part of the picture. You'll also need to account for the clinical visit required to get a prescription and follow-up appointments for medication management. These can add to your total expense, particularly if you're uninsured.

Naltrexone cost with insurance

Most major insurance plans cover naltrexone in some form. If you have insurance, your actual costs will depend on whether you've met your deductible, your plan’s copay structure, and your pharmacy benefits. We always recommend checking your insurance coverage before assuming what you'll pay.

Generic naltrexone insurance pricing

Most commercial insurance plans cover at least part of the generic naltrexone cost. All 50 state Medicaid plans include medication-assisted treatment (MAT) coverage, and Medicaid covers generic naltrexone in most states. This includes Pennsylvania, New York, and New Jersey, the primary states where Ophelia operates.

One study found that 84.2% of 241 Medicaid managed care plans (MCPs) include oral naltrexone in their formularies, or Preferred Drug Lists (PDL). These are curated lists of generic and brand-name prescription drugs covered under a specific health insurance plan.

Medicare Part D generally covers oral naltrexone as well. Copays are manageable for most people with insurance, and many pay as little as $0 to a few dollars per month.

Vivitrol insurance pricing

Vivitrol coverage varies under commercial insurance plans, but 99% of patients with any insurance—including Medicaid—have some coverage.

Medicaid health plans in all 50 U.S. states and the District of Columbia cover Vivitrol for some planholders. However, eligibility requirements can vary by state and plan. Vivitrol’s manufacturer notes that 99% of individuals with Medicaid paid $4 or less for their monthly prescription as of September 2024.

Fifteen U.S. states, the District of Columbia, and Puerto Rico require prior authorization for Vivitrol coverage. This means your provider must submit clinical documentation to your insurer, which could delay the start of treatment.

Checking insurance coverage with Ophelia

Ophelia accepts a growing number of insurance plans for OUD treatment, including Medicaid, Medicare, and commercial insurance in many states. Patients often pay less than $10 per month for buprenorphine-based care through Ophelia, with no surprise fees. This usually includes clinician visits, Suboxone management, and ongoing support; medication coverage depends on the patient’s insurance plan.

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Use our insurance coverage tool to select your state of residence and see if your care may be covered by insurance. Once you check your coverage, give us a call to confirm eligibility.

How to reduce the cost of naltrexone

If you’re uninsured or underinsured, there are several ways to lower your out‑of‑pocket expenses.

GoodRx and discount programs

GoodRx, SingleCare, and other discount card websites provide coupons for generic naltrexone. These coupons can reduce the cost of medications by up to 80% at participating pharmacies. Over 70,000 U.S. pharmacies accept GoodRx, and over 35,000 accept SingleCare.

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These discount programs work even without insurance. You simply search for your medication on the program website, compare prices, and choose a nearby pharmacy with a low rate. You will show your coupon to the pharmacist to receive your discount when you pick up your medication.

Vivitrol savings program

Alkermes, the manufacturer of Vivitrol, offers a copay savings program for eligible individuals with commercial insurance who still face high costs. Nine out of ten eligible patients pay less than $5 for their monthly prescription, and 91% pay zero out-of-pocket expenses. This copay program does not apply to Medicaid, Medicare, or other federal or state healthcare programs.

Mail-order pharmacies

Some people find lower per-unit pricing through mail-order pharmacies, which are especially convenient for ongoing prescriptions. A few popular options include Express Scripts, CVS Caremark, and Optum Home Delivery. In many cases, you can receive a 3-month supply of your medication.

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Here’s how it works: either your provider submits your prescription to the pharmacy electronically, or you send your original paper prescription alongside a completed order form through the mail. The pharmacy fills your medication and ships it securely to your home. Shipping costs and timelines vary, so weigh these factors before choosing a mail-order pharmacy.

‍Note: Naltrexone purchased outside the U.S. or through non-licensed channels carries real legal and safety risks. Stick to licensed U.S. pharmacies to ensure safety.

Federally funded programs

Some clinics receive federal funding that allows them to provide medication at reduced or no cost. Use SAMHSA’s state agency locator to identify programs in your area that may pay for some or all of your prescription.

Naltrexone vs. buprenorphine: cost comparison

Naltrexone and buprenorphine/naloxone (Suboxone®) are both FDA‑approved for treating OUD. They work differently, and cost is only one factor to consider. Since many people compare the two treatment options, here’s a quick pricing comparison.

Beyond cost, it’s important to understand that naltrexone requires a full opioid detox before starting treatment. You can begin using buprenorphine under clinical guidance while opioids are still in your system, and it’s designed to reduce withdrawal symptoms and cravings early in care. That’s one reason buprenorphine monoproduct and buprenorphine/naloxone are commonly used as first-line options for opioid use disorder.

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Keep in mind that the appropriate medication depends on your history, your goals, and your care team’s clinical judgment.

OUD treatment with Ophelia

Ophelia provides evidence-based OUD treatment through telehealth primarily using buprenorphine/naloxone (Suboxone). In-person visits are never required, and you can meet with a clinician via secure video chat in just 1–3 days.

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Care is 100% online and judgment-free. You’ll be matched with a dedicated care team who will determine whether medication is appropriate based on your needs, individual history, and goals.

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Our telehealth model includes the cost of care:

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• Online clinician visitso
• Prescription management
• Ongoing support

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Ophelia accepts most commercial insurance plans, as well as Medicaid and Medicare. Many patients pay less than $10 per month, depending on coverage.

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Frequently asked questions

Can I get naltrexone for free?

Possibly. Some federally funded programs offer free or low‑cost naltrexone. Medicaid covers generic oral naltrexone in most states, so patients on Medicaid often pay little to nothing for their medication. GoodRx and similar discount programs can also bring costs close to zero for generic tablets at participating pharmacies.

Does GoodRx work for Vivitrol?

No. Vivitrol is a specialty medication, and coupons from GoodRx and similar discount programs are not available at specialty pharmacies. The manufacturer’s copay savings program is usually the best option for individuals with commercial insurance.

Why is Vivitrol so expensive without insurance?

Vivitrol is a brand-name, extended-release injectable. The manufacturing process for Vivitrol is more complex than for a daily pill, which drives up the cost. A generic version of the medication is expected as early as 2027.

How long will I need to take naltrexone, and does that affect the total cost?

OUD treatment duration varies from person to person, so there is no established timeline. Some people take naltrexone for a few months, while others continue medication management long-term. Because monthly costs add up over time, formulation and insurance coverage are both important considerations when choosing a medication.

Is naltrexone available at all pharmacies?

Generic oral naltrexone is widely available at most major chain and independent pharmacies. Vivitrol may not be stocked at every location and may require ordering ahead.