Frequently asked questions
Here, you’ll find answers to the most common questions patients have. Use the topics list to find what you’re looking for.
People regularly using opioids who want to control or stop their use as well as those who don't need a higher level of care for acute medical or psychiatric issues.
At the moment, Ophelia clinicians primarily prescribe Suboxone or the generic Buprenorphine + Naloxone combination. We can also prescribe medication for symptoms related to withdrawal during induction, such as nausea or trouble sleeping, and medication for depressive, anxiety, and insomnia disorders.
Ophelia is 100% committed to your privacy and confidentiality. We will never share your information with anyone without your permission, including your employer. Read more about our Notice of Privacy Practices here.
The subscription-based service costs $195 a month without insurance. It includes: all Ophelia clinician visits via video calls, suboxone management, and ongoing support from the dedicated Ophelia care team.
In order to respect our clinician’s time, and to respect the time of other patients who are waiting to be seen, Ophelia does charge no-show fees on visits. For initial visits (the very first appointment with your clinician), we charge $20 if the visit is no-showed or canceled within 12 hours of the start time. For Follow-Up Visits, because these are scheduled weeks in advance, we charge a $20 fee if the visit is no-showed or canceled within 24 hours of the start time.
Ophelia does not charge any late fees for payment. We want to be as flexible as possible with our patients, so as long as there is open and honest communication we can accept late payment without fee. If payments are consistently late or missing, however, this may lead to discussions of discharge.
Unfortunately, if a patient can no longer pay for treatment we will have to initiate discharge. This does not mean that the patient will be abruptly kicked out of treatment without any support though. If we know discharge is coming, our care team will begin working with the patient on a discharge plan, including a list of referrals for other Opioid Use Disorder clinics and programs. Our clinicians will also prescribe a discharge script of medication, meaning that patients will not be without any medication as they enroll in new treatment.
Our monthly fee of $195 covers all of your care for that month! This covers all visits, care coordination, peer support services, and optional support groups! We do not charge extra for each visit or additional services.
As you sign up for your initial visit with a clinician, you will be asked to put in your payment information to confirm the appointment. We need this information to schedule the visit, but you will not be charged yet! The first visit is risk free, meaning that we will not charge you unless you decide to enter treatment. If you talk with the clinician for 45 minutes, and then decide Ophelia isn’t the right fit for you, you won’t be charged anything! If you do join treatment, then we will charge the first $195 right after your visit. If you are unable to pay at that time, we can delay your first payment up to one week after your initial visit.
Zoom is completely free to download and use.
Most insurance plans will cover the price of medication with only small copays to be paid by the patients.
If you do not have insurance, the price of the medication will have to be paid for out of pocket. The price can vary depending on how much you are prescribed, the type of medication, and the dosage. We have some tools we use that can help lower the cost of the medication, so please ask about these if you are interested!
We are in network with a number of insurance plans, which you can see on this page on our website
Unfortunately, there’s not a clear answer to this question. The cost of copays depends on your insurance plan, your deductible, and a few other factors. As a result, we won’t know the copay amount until we submit the first claim. If you would like to know this information sooner, we recommend calling the member services number on the back of your insurance card and inquiring with your insurance provider directly.
For most of our patients, insurance does cover the full cost of the medication, or requires small copays of less than $10. Depending on the details of the prescription and your insurance plan, sometimes we need to file prior authorizations for the insurance company to cover the cost. Ophelia will happily complete and submit these documents for our patients.
In order to book an Initial Visit with Ophelia, we do require a card for payment on file, even if we accept a patient's insurance. We still need the card for a few reasons. The first is copays - as we bill insurance for our services we are legally required to collect copays from our patients, so we must have a payment method on file to do so. Additionally, there are cases where a patient's insurance expires or is no longer acceptable, so we need to have a payment method on file to revert these patients back to out of pocket payment.
During your treatment with Ophelia, there are three people you will interact with.
First is your Enrollment Coordinator. As you are getting ready to schedule your first visit with Ophelia, your Enrollment Coordinator will be there to help you every step of the way. They will get on the phone with you to explain what our treatment looks like, answer any questions you have, and help you schedule your first visit.
Care Coordinators (CCs). Your Care Coordinators will be working with you throughout your treatment at Ophelia and are here to support in any way they can. CCs can help you reschedule appointments, call your pharmacy or insurance company about prescription issues, find you a referral for other care providers in your area, and can be booked for support calls if you want that extra bit of support.
Next you will meet your clinician. Your clinician will review your medical history with you, propose a treatment plan, and then manage your prescriptions. You and your clinician will meet frequently throughout the first month of treatment.
At Ophelia, all of our visits are done through Zoom. Zoom is a free to download video chat app that you can get on your smartphone, computer, or tablet. When you schedule a visit, we will send the Zoom link to your email, and then we will text it to you closer to when your visit starts! Once you have Zoom downloaded on your device, all you’ll need to do is click on the Zoom link, and it will open up the video call for you!
During the first month of treatment, patients will have visits with their clinician once a week as they are stabilizing onto their medication. After the first month or so, patients will begin meeting with their clinician once every two weeks, and then after the third month, patients will have once a month check-ins.
Every patient’s treatment plan is different, so there’s no set schedule for appointments.
Suboxone is a combination medication of Buprenorphine and Naloxone. It’s a partial opioid that binds to the same receptors in the brain as traditional opioids and reduces cravings and withdrawal symptoms. It does not produce the same “high” at a therapeutic dosage, so you can feel physically healthy and remain clear-headed all day.
Rx Only. SUBOXONE is indicated for the treatment of opioid dependence in adults. SUBOXONE should not be taken by individuals who have been shown to be hypersensitive to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported. Taking SUBOXONE with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants can cause breathing problems that can lead to coma and death. Other side-effects may include headaches, nausea, vomiting, constipation, insomnia, pain, increased sweating, sleepiness, dizziness, coordination problems, physical dependence or abuse, and liver problems. For more information about SUBOXONE, see the Suboxone Safety Information page, the full Prescribing Information, and Medication Guide or talk to your healthcare provider.