Understanding insurance coverage for Suboxone and MAT: A guide for Keystone First members in Pennsylvania

Does Keystone First insurance cover Suboxone and MAT? Explore the accessible care options available through Ophelia’s partnership with Keystone First.

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Access to medications for addiction treatment (MAT) and Suboxone medication is crucial for individuals seeking treatment for opioid use disorder (OUD). As a Keystone First member in Pennsylvania, understanding your insurance coverage for these treatments is essential. In this article, we will delve into the insurance coverage provided by Keystone First, including their partnership with Ophelia to expand access to Suboxone and MAT. By gaining insights into your coverage, you can confidently pursue your journey toward a healthier life.

Does Keystone First cover MAT?

MAT—which combines medications for addiction treatment, such as Suboxone, with counseling and behavioral therapies—is widely recognized as the most effective treatment approach for OUD. Individuals with Keystone First are eligible for coverage for MAT services.

Does Keystone First cover Suboxone for OUD?

Individuals with Keystone First insurance are eligible for the coverage of evidence-based treatment for opioid addiction and medications used in MAT, including Suboxone. As a Keystone First member, you have access to Suboxone through participating providers, including the option to utilize our services. However, it's important to note that coverage for specific medications can vary depending on your insurance plan's formulary. Please consult your plan documents or contact Keystone First directly to confirm the inclusion of Suboxone or similar medications in your plan's formulary.

Understanding your Keystone First insurance coverage for Suboxone and MAT:

Use the following steps to navigate your insurance coverage effectively:

  1. Review insurance policy and formulary: Take the time to review your Keystone First insurance policy documents and formulary. Look for sections that outline coverage for addiction treatment, prescription medications, and the specific medications used in MAT, such as Suboxone.
  2. Consult with Ophelia: We can provide additional guidance and support in understanding your insurance coverage with Keystone First. Our care coordinators can help you navigate the insurance process, answer questions specific to your treatment plan, and assist with any financial concerns. Text us today at (215) 585 2144.
  3. Contact Keystone First: Reach out to Keystone First directly to inquire about your coverage for Suboxone and medications for addiction treatment (MAT).

Using Keystone First insurance with Ophelia for effective treatment

Meet your clinician via a video call from the comfort of your home and get quick access to medication that will relieve withdrawal. Using Keystone First insurance with Ophelia empowers you to pursue effective treatment for opioid addiction. Start your journey to recovery today and experience the benefits of online MAT.


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