Wellpoint NJ Medicaid for Subxone® + MAT

Understanding the ins and outs of insurance coverage is one of the biggest hurdles to seeking treatment. This can be doubly true for those who need Suboxone® treatment for opioid use disorder (OUD).

In New Jersey, one of the most common providers of Medicaid is Wellpoint, and many NJ Suboxone doctors work with Wellpoint to provide comprehensive Suboxone treatment services. In this guide, you’ll find details on how to get top-quality treatment for OUD while working with your insurance to ensure the process is both effective and affordable. 

How to get Suboxone with Medicaid

Exactly how to get Suboxone with Medicaid depends on many factors, such as where you live, what treatment methods are viable for you, and how you get your insurance coverage. Individuals who have insurance with Wellpoint Medicaid have several options for seeking Suboxone treatment, but the details will be different for each person.

In general, it’s possible to get Suboxone through both outpatient and inpatient treatment programs. Some of these involve visiting a physical clinic and seeing doctors in person, but there are also telehealth options for Suboxone treatment, allowing patients to seek care remotely. This option is especially useful for people who live in rural areas or those who don’t have reliable access to transportation. 

Seeking Suboxone treatment with Wellpoint Medicaid

How does Wellpoint cover Suboxone treatments?

Wellpoint is one of the Medicaid programs that covers several forms of Suboxone treatment through NJ Family Care and Medicaid¹. As part of their general substance use disorder treatment programs, Wellpoint also offers therapy and counseling services, detox and withdrawal programs, and outpatient treatment. You can search the provider directory to find care.

Suboxone prescriptions are covered in several different forms. The drug’s generic formulations are covered as a sublingual film in doses ranging from 0.5mg to 12mg, while the generic sublingual tablet is available from 0.5mg to 8mg.

Name brand Suboxone is on the insurer’s list of non-preferred drugs, but it can be covered in certain instances. No matter what form the drug comes in, it has strict quantity limits determined by the insurance company. To find out more information, you can search Wellpoint’s online formulary. 

Does Wellpoint Medicaid cover telehealth?

In addition to covering in-person treatment services, Wellpoint Medicaid also offers coverage of remote telehealth services. In fact, a telehealth treatment program is one of the easiest and most reliable ways for many patients to receive Suboxone treatment. The advent of telehealth has made OUD treatment more accessible than ever. Patients can receive discrete treatment from the comfort of their own homes, and they no longer have to commit to long drives and time-consuming in-person visits.

Telehealth OUD treatment is more convenient for people who work remotely, live in rural areas, don’t have access to reliable transportation, or want to ensure privacy during treatment. 

Here at Ophelia, we provide comprehensive and personalized care remotely, and we work with many major insurance providers, including Wellpoint Medicaid. 

Are there additional benefits

For those seeking more than just treatment of symptoms, Wellpoint Medicaid offers several “Learning Tracks” designed to help patients build holistic change in their lives². These programs are focused on healing the body and mind, and they include assistance with finances, grief, trauma, and addiction by encouraging healthy and structured habits and teaching methods for maintaining good mental health and managing dangerous triggers.

It’s also possible to get harm reduction supplies to help yourself and your community avoid dangerous overdoses due to opioid use. Some NJ Suboxone doctor’s offices can provide prescriptions for naloxone, an opioid antagonist used to reverse opioid overdoses, and pharmacies in New Jersey can provide naloxone without a prescription to those in need³. There are also mutual aid and harm reduction groups, like the New Jersey Harm Reduction Coalition, that can provide naloxone free of charge. 

What does telehealth Suboxone treatment look like?

How telehealth with Ophelia works

While it might sound scary, telehealth is quite straightforward. When first starting with Ophelia, you’ll first meet with the Enrollment Coordinator, who helps navigate your insurance and schedule your future visits. Afterward, your Ophelia appointments take place on Zoom, where you get face-to-face time with a specialist in Suboxone treatment. This clinician will first build a personally tailored treatment for you based on your history and needs, and then you’ll begin induction, which includes your first doses of Suboxone.

After induction, you’ll have weekly meetings with your clinician during the stabilization period. This stage may include periodically taking remote drug tests or adjusting your meds as needed. Once you’re stable, Ophelia offers ongoing care that includes medication, counseling and mental health services, and peer coaching.