UnitedHealthcare (UHC) is one of Pennsylvania’s major healthcare providers, including among Medicaid recipients. One of the most important benefits available to their customers is telehealth coverage. This crucial service makes medical care accessible to patients at a moment’s notice, even if they’re miles from the nearest clinic or leave the house. Remote access is particularly useful for patients seeking treatment for opioid use disorder who might be deterred by the cost and travel requirements associated with other types of OUD treatment.
How do I know I’m eligible for Medicaid through UHC?
State Medicaid, known as the Pennsylvania Medical Assistance program, is offered through the state to ensure that quality healthcare is available to PA residents who can’t otherwise afford it or don’t have access through other means, such as an employer-sponsored plan. UnitedHealthcare is one of the major providers of Pennsylvania Medicaid, covering individuals and families in Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.
Those seeking coverage can apply for Medicaid through the state, and it’s also possible to check your eligibility with UHC directly. Luckily, Medicaid covers many drug treatment services, and there are many Suboxone doctors who accept UnitedHealthcare, which makes help for opioid use disorder more accessible.
How to get Suboxone® with Medicaid
Suboxone treatment for opioid use disorder (OUD) is covered by Medicaid in Pennsylvania, making the medication free to patients (important safety information). There are quantity limits depending on the prescription’s dosage and frequency; however, most treatment plans will not exceed the state’s quantity limits for these drugs. To get started with a Suboxone treatment plan, a patient simply needs to get in touch with a health care provider specialized in opioid treatment and enroll in their services.
Typically, this process involves an easy intake appointment with a care professional who specializes in addiction treatment. Their job is to evaluate the patient’s situation and determine whether they meet the criteria for Suboxone treatment. Eligible patients receive a Suboxone prescription right away. The entire process can be done privately and remotely, without any need to go to an in-patient clinic. Telehealth interviews can be conducted through a voice or video call, making scheduling and attending these appointments easier than ever.
At Ophelia, we offer comprehensive telehealth services for Suboxone treatment for Medicaid recipients. We work with a growing list of insurance plans, including UnitedHealthcare, to ensure PA Medicaid recipients can use our program with full insurance coverage.
What does telehealth treatment for OUD look like?
With the advent of telemedicine, OUD treatment is vastly more accessible than it has been in the past. UHC-covered Suboxone treatment with Ophelia takes place over a series of remote telehealth visits. Each visit takes place on a voice call or on a video call service and works much like a typical visit to the doctor’s office. Patients share any relevant information with the medical professionals on the call, who evaluate the patients’ needs and progress.
Suboxone treatment typically starts with an intake appointment; this is when the attending team can answer questions about the process and make sure your insurance, treatment eligibility, and privacy are in order. After that, you’ll meet with a clinician to develop a treatment plan. The clinician will assess the stated history of opioid use, provided medical history, and description of your social environment. This information helps our care teams determine whether Suboxone and any other maintenance medication are needed.
Once you receive your prescription, it’s time to start the induction process with the care team’s help. This process requires you to stop using opioids until withdrawal starts to set in; at this point, you’ll take the first dose of Suboxone. This process is delicate, so care providers will be remotely available to help and will check in regularly during the first few days of treatment.
During the stabilization phase of treatment, you’ll schedule weekly visits with OUD treatment specialists to evaluate your progress and adjust meds as needed. This phase also involves occasional remote drug testing to establish a baseline and ensure you’re avoiding non-prescription opioids.
Once this period is over, a patient advances to the maintenance stage and only needs to check in with their provider monthly to renew prescriptions and report on their progress. But if there are any issues during this time, your care team is available to help.
Finding naloxone locally
The opioid overdose-reversal medication naloxone, also sold as Narcan, is also available to Pennsylvania Medicaid recipients using UnitedHealthcare. In addition to receiving naloxone through a prescription, it’s possible to acquire naloxone locally through various initiatives dedicated to helping address the opioid epidemic. Keeping this medication on hand and connecting friends and family members with distribution points can be a life-saving step during OUD treatment.
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