Independence Blue Cross/AmeriHealth NJ for Suboxone® + MAT

Insurance coverage can be incredibly detailed and hard to navigate, but understanding your benefits is a crucial first step when seeking care. The process is especially important for individuals seeking opioid addiction treatment in New Jersey. Overdose-related deaths have been declining in the state, with a 26% drop in the first six months of 2024 compared to the same time period in 2023¹, but there’s still more work to do.

Getting medical help approved through insurance companies, such as Independence Blue Cross—and their AmeriHealth affiliate²—can lead to better outcomes for individuals seeking opioid addiction treatment in New Jersey. In this guide, you’ll find important information about AmeriHealth coverage and telehealth options for opioid treatment.

What you need to know about AmeriHealth rehab coverage in New Jersey

Can Medicaid recipients get opioid addiction treatment in NJ?

Whether you’re seeking information about care for yourself or a loved one with Medicaid, you’ll find that OUD treatment coverage through AmeriHealth is available in a number of forms. AmeriHealth has a specialized Behavioral Health team to help members assess their recovery needs and find in-network care. Several crucial medications, such as Suboxone®—and buprenorphine and naloxone generics—are covered as Tier 1 medications³ (important safety information).   

Are there telehealth options?

Receiving care for opioid use disorder treatment has never been easier thanks to the availability of telehealth solutions. In-person treatment can present challenges for many people, from privacy concerns and geographic limitations to work and family obligations that can make being away for extended periods difficult. Independence Blue Cross and AmeriHealth in New Jersey offer several telehealth options for Medicaid patients who can’t or don’t want to receive in-person treatment.

Getting remote access to opioid treatment services and medications saves lives and increases the efficacy of treatment. Ophelia’s intake team will help you determine whether your insurance covers our services before committing to the process. 

Are there other benefits I should know about?

Treating opioid use disorder is most effective when patients also receive behavioral support to address factors that might be contributing to or stemming from their drug use. Many Suboxone treatment providers, including Ophelia, offer referrals to connect patients with additional services. Our enrollment coordinators will help you identify which services are covered under your AmeriHealth plan.

There may also be county-level and local initiatives available to increase access to treatments, services, and medications. For example, naloxone­—a drug used to reverse opioid overdoses—is available over the counter⁴ and may be distributed by local mutual aid and harm reduction organizations.

Navigating telehealth opioid addiction treatment in NJ

Telemedicine isn’t much different from a regular doctor’s appointment. You’ll meet with a clinician to discuss symptoms and issues and develop a personalized treatment plan. Everything is confidential and secure, just like it would be during an in-person appointment. The only difference is that we conduct patient calls through Zoom. Appointments are entirely remote and can be done from anywhere you have an internet connection. 

This approach makes high-quality healthcare more accessible to patients who live in rural areas and would have to travel long distances to receive treatment, as well as those who can’t take time away from work, school, or family. Removing these barriers makes it easier for patients to stick with their appointment schedule and treatment plan, leading to better outcomes.

Starting with Ophelia

Getting started with Ophelia for opioid addiction treatment in New Jersey is easy. First, you’ll set up an initial appointment with our Enrollment Coordinator to verify insurance coverage and learn about our privacy protections. Then, the coordinator will schedule a clinician meeting. 

The initial visit 

When you meet with a clinician over Zoom, you’ll discuss your medical history, including substance use history. Your clinician will use this information to create a treatment program that best meets your needs. If your clinician believes a Suboxone prescription is the right approach, they’ll send the prescription to the pharmacy of your choice. 

Induction

When your prescription arrives, it’s time to start the induction process. This process can be uncomfortable, but it’s crucial to a successful treatment. It involves abstaining from opioids long enough for the beginning stages of withdrawal to take place. Unsupervised and untreated, opioid withdrawal is uncomfortable and potentially dangerous, but our team will be on call 24/7 to help you through the process, which can include support medications as needed. Once withdrawal has been successfully induced, it’s time to take your first dose of Suboxone. This will help quell the worst symptoms of withdrawal while also curbing cravings. 

At this point, you’ll also complete a remote urine testing to establish a baseline for your care. Your clinician will walk you through the steps of opening and using the test kit during a video call. We take a non-punitive approach to urine testing, meaning we don’t punish people or kick them out of treatment for a result showing substances other than buprenorphine.

Stabilization

After induction, you’ll begin taking Suboxone at regular dosages and intervals and meet with a clinician weekly to discuss treatment progress. The goal of these follow-up visits is to find the ideal treatment plan and maximize patient comfort and progress. Once you’re stable, you’ll have access to a range of individualized support options, including therapy and treatment for other mental health issues, like depression, anxiety, and insomnia.

If you’re an AmeriHealth customer in New Jersey, Ophelia is here to make opioid treatment easier and more accessible. Call our enrollment team today to discuss your insurance coverage and care options.