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Vivitrol is a medication used to treat alcohol and opioid addiction. It is a prescription medication commonly used to treat alcohol and opioid dependency in individuals with a history of chronic use. The cost of Vivitrol is a concern for many, as it can be as high as $1000 per dose. However, many health insurance plans cover Vivitrol prescriptions, and eligible patients with commercial insurance may pay as little as $0 per prescription. The coverage depends on the specific insurance plan and where the treatment is received. It is important to verify insurance coverage before starting treatment to avoid unexpected costs.
| Characteristics | Values |
|---|---|
| Cost of Vivitrol shots | Around $1000 per dose |
| Commercial insurance or no insurance | Eligible patients may pay as little as $0 per prescription of Vivitrol |
| Maximum savings per prescription | $500 up to 12 prescriptions per calendar year |
| Maximum savings per year | $6,000 per calendar year |
| Patients' out-of-pocket expenses | May vary |
| Offer validity | Not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs |
| Additional terms and conditions | Applicable |
| Insurance coverage | 99% of people with insurance are covered for Vivitrol, including most government and commercial plans |
| Medicaid coverage | In some states, Medicaid covers Vivitrol prescriptions |
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What You'll Learn
Commercial insurance may cover Vivitrol
If you have commercial insurance, you may be eligible to pay as little as $0 per prescription of Vivitrol. The maximum savings per prescription is $500 for up to 12 prescriptions per calendar year, with maximum savings of up to $6,000 per calendar year. Patients' out-of-pocket expenses may vary. This offer is not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs.
To see if your insurance can help cover the cost of Vivitrol, you can fill out a form online. A Vivitrol2gether customer service specialist will then contact you by email or phone to review your results. You can also call 1-800-VIVITROL to connect with a Vivitrol2gether patient support representative, who can help you with any questions about how to get started with Vivitrol treatment.
If you are being treated for alcohol dependence but are also addicted to opioid-containing medicines or opioid street drugs, it is important to tell your healthcare provider before starting Vivitrol to avoid having sudden opioid withdrawal symptoms.
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Patients may pay $0 per prescription
The cost of prescription medication can be a concern for many patients, especially when it comes to expensive, brand-name drugs. Fortunately, there are options available to help reduce the financial burden, such as patient assistance and manufacturer copay programs. These programs can often lower out-of-pocket expenses to $0 per month, providing much-needed relief for those struggling to afford their medications.
In the case of Vivitrol, a medication used to treat opioid and alcohol dependence, eligible patients may pay as little as $0 per prescription. This offer is available to those with commercial insurance or even no insurance at all, providing a significant cost-saving benefit. The maximum savings per prescription is $500, and patients can receive up to 12 prescriptions per calendar year, resulting in potential annual savings of up to $6,000.
It is important to note that this offer is not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. Additionally, out-of-pocket expenses may vary, and there are terms and conditions that apply. To fully understand the coverage provided by your insurance plan, it is recommended to review your plan's benefits, contact your insurance company, or speak with a healthcare provider.
If your insurance does not cover the cost of Vivitrol, there are still options available to help reduce the financial burden. Patient assistance and copay assistance programs may be available to help lower out-of-pocket costs. Additionally, you can request an exception from your insurance company or appeal their decision if they deny coverage. Remember that each appeal or objection will require a letter of medical necessity from your doctor.
In summary, the prospect of paying for expensive prescription medications can be daunting, but there are resources available to help. With options like patient assistance programs and insurance coverage, patients may be able to access the treatments they need at a more affordable cost. By understanding their insurance coverage and exploring available assistance programs, patients can make informed decisions about their healthcare and find ways to reduce their financial burden.
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Maximum savings are $6,000 per year
The cost of Vivitrol prescriptions varies depending on the patient's health plan. Some health plans cover Vivitrol as either a medical or pharmacy benefit. If you have commercial insurance or no insurance, you may pay as little as $0 per prescription of Vivitrol. The maximum savings per prescription is $500 for up to 12 prescriptions per calendar year, with maximum savings of $6,000 per calendar year. This means that eligible patients can avail of up to $500 off per prescription for up to 12 prescriptions, equalling a maximum of $6,000 in savings in a year.
If you are unsure about your insurance coverage, you can fill out a form to see if your insurance can help cover the cost of Vivitrol. You can also contact a Vivitrol2gether patient support representative by calling 1-800-VIVITROL (1-800-848-4876) to learn about possible savings on your Vivitrol prescription.
It is important to note that Vivitrol has significant risks, including the risk of opioid overdose, severe reactions at the injection site, sudden opioid withdrawal, liver damage, or hepatitis. Before starting Vivitrol treatment, patients must be opioid-free for at least 7 to 14 days to prevent sudden opioid withdrawal, which can be severe and may require hospitalization.
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Out-of-pocket expenses may vary
Out-of-pocket expenses for Vivitrol prescriptions may vary. The cost of Vivitrol shots is usually around $1000 per dose, which can be unaffordable for many individuals seeking substance abuse treatment who do not have health insurance. However, eligible patients with commercial insurance or no insurance may pay as little as $0 per prescription of Vivitrol, with maximum savings of up to $6,000 per calendar year.
The process of obtaining Vivitrol depends on the patient's health plan. Some health plans allow any network pharmacy to fill Vivitrol prescriptions, while others require the use of a specialty pharmacy. Specialty pharmacies obtain and ship patient-specific prescriptions to the healthcare provider's office and bill the patient's insurance directly, collecting any co-pay from the patient.
To determine if your insurance covers Vivitrol, you can fill out a form on the Vivitrol website or contact a Vivitrol2gether patient support representative. Additionally, you can reach out to a pharmacy of your choice to inquire about the cost of Vivitrol. It is important to check with your insurance provider and understand your coverage before starting treatment with Vivitrol.
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Medicaid may cover Vivitrol in some states
Medicaid health plans cover Vivitrol in all 50 states and the District of Columbia. However, eligibility requirements for receiving Medicaid coverage for Vivitrol may vary according to your state of residence and the type of Medicaid coverage plan you have. For instance, prior authorization for Medicaid coverage of Vivitrol is required in 15 U.S. states.
Vivitrol is a long-acting, injectable medication that is used to treat alcohol and opioid use disorder. It is FDA-approved to treat these disorders and is prescribed alongside other support services as part of a medication-assisted treatment (MAT) program.
The cost of monthly Vivitrol shots with Medicaid coverage can vary. A single Vivitrol prescription costs about $1,200 before adjusting for federal basic and inflation rebates. However, with Medicaid coverage, pharmacy coupons, and drug discounts, this is not a cost you may be responsible for covering by yourself. To learn how much Vivitrol costs with your Medicaid plan, you can refer to your individual policy or contact an insurance representative for more information.
It is important to note that Vivitrol may not work for everyone, and it is not known if it is safe for children. Additionally, there are significant risks associated with Vivitrol treatment, including the risk of opioid overdose, severe reactions at the injection site, sudden opioid withdrawal, liver damage, or hepatitis.
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Frequently asked questions
It depends on your health plan. 99% of people with insurance are covered for Vivitrol, including most government and commercial plans. To find out if your insurance covers Vivitrol, fill out a form and a customer service specialist will contact you to review your results.
You can fill out the form online or call 1-800-VIVITROL (1-800-848-4876) and select option 4 to connect with a Vivitrol2gether patient support representative, who can help you Monday–Friday, 9:00 AM–8:00 PM (ET).
Eligible patients who have commercial insurance or no insurance may pay as little as $0 per prescription of Vivitrol. The maximum savings per prescription is $500 for up to 12 prescriptions per calendar year, with maximum savings of up to $6,000 per calendar year.
The offer of $0 per prescription is not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. However, in some states, Medicaid covers Vivitrol prescriptions.
