Are you looking for a way to end your opioid use for good? Have you tried managing your withdrawal on your own, only to end up returning to use?
You know it’s time to try something different. You’re interested in trying medication-assisted treatment (MAT) because you know it will reduce your cravings and get you through the worst of your withdrawals more effectively.
You’re not alone in taking buprenorphine while in treatment for opioid use disorder (OUD). As of 2023, the buprenorphine dispensing rate was over 5 out of every 100 people in Virginia, according to the Centers for Disease Control. The dispensing rate was over 10 in every 100 people in Tennessee. The vast majority of these people get their treatment covered by insurance.
At ReVIDA® Recovery, we want you to choose the medication that works best for your recovery. We also want you to understand exactly what it is and how you’ll pay for it. So, when you ask, “Does insurance cover Sublocade?” we’ll tell you that yes, insurance usually covers Sublocade. Today, we’ll detail what Sublocade is and how you can get it covered by insurance.
Table of Contents
What Is Sublocade? Everything You Need to Know
Sublocade is a medication used to treat opioid use disorder. Its extended-release formula is administered by a doctor once a month. Sublocade starts as a liquid and takes the form of a gel when it enters your body. The small pocket of gel, known as a depot, releases a steady amount of the medication into your bloodstream throughout the month.
Buprenorphine is the active ingredient that makes Sublocade effective. It’s a partial opioid agonist, which means it connects to the opioid receptors in your brain and body the same way a traditional opioid would. However, buprenorphine has a ceiling effect, which means it doesn’t make you feel “high” like other opioids do. Since it’s already connected to the opioid receptors in your brain, it also prevents you from feeling the effects of other opioids if you take one.
You don’t have to stay on Sublocade forever to live without opioids. The medication is designed to limit the extent of your withdrawal symptoms and reduce cravings, empowering you to make a healthy transition to an opioid-free life. The exact amount of time you’ll be on Sublocade is unique to you. You should ask your doctor questions about the length of treatment and make that decision together.
How Does Sublocade Work, and What Are the Benefits?
There are many benefits to the Sublocade shot. The medication works by improving your withdrawal symptoms and reducing cravings for opioids. Sublocade also reduces the likelihood of acute withdrawal symptoms and post-acute withdrawal syndrome (PAWS).
The Defining Symptoms of Acute Opioid Withdrawal
During the first stages of opioid withdrawal, you’ll likely find it difficult to focus on anything else. Cravings can feel like they are the only thing in the world that matters, and you have to satiate them. Sublocade drastically reduces their intensity and allows you to focus on other aspects of healing, like individual and group therapy.
Acute withdrawal symptoms often mimic the flu. They include:
- Aching muscles
- Intense sweating
- Excessive yawning
- Insomnia or trouble sleeping
- Runny nose
- Watery eyes
- Agitation
- Anxiety
- Dilated (large) pupils
Recognizing the Symptoms of PAWS
PAWS symptoms are usually more psychological. They’re not as consistent as acute withdrawal symptoms, but they do last longer. These symptoms recur periodically for months or sometimes even years after you end your opioid use. Sublocade reduces the intensity of your symptoms.
Symptoms of PAWS include:
- Brain fog or trouble thinking things through
- Anxiety or depression
- Intense mood swings
- Impulse control issues
- Aggression, or hostility
- High sensitivity to stress
Does Insurance Cover Sublocade at ReVIDA®?
Yes, most insurances cover Sublocade to treat OUD. There may be specific circumstances that limit the coverage offered by your insurance. The best way to find out if your specific insurance covers the medication is to call them and ask.
Where you go to receive your Sublocade shot could also impact your coverage. At ReVIDA® Recovery, we work with most major insurance companies.
At our Tennessee locations, we accept:
- Blue Cross Blue Shield of Tennessee
- United Healthcare
- Amerigroup
- Medicare
- Humana Behavioral Health Care
- Aetna
- Ambetter of Tennessee
- Cigna Healthcare Evernorth
- Farm Bureau Insurance
Our Virginia locations’ insurance options are slightly different but include:
- Aetna
- Anthem Blue Cross Blue Shield
- Optima Health
- Virginia Premier
- Magellan Healthcare
- Molina Healthcare
- United Healthcare
- Medicare
- Humana Behavioral Healthcare
- Cigna Healthcare Evernorth
Other MAT providers may accept different insurance options.
In most cases, Sublocade is covered by Medicaid as well. Medicaid, known as TennCare in Tennessee and Cardinal Care in Virginia, provides healthcare to people living on low incomes and with certain medical conditions. The specific qualifications for Medicaid vary slightly from state to state. To learn more about whether or not you qualify for Medicaid, visit the TennCare or Cardinal Care websites, respectively.
When Does Insurance Typically Cover Sublocade?
The specific qualifications may vary depending on your insurance provider. Usually, you have to have a diagnosed opioid use disorder, and you must be receiving treatment from a qualified medical professional. There may be a limit to the number of doses or the amount of time your insurance provider will cover Sublocade.
You should talk to your doctor and your care team about the best way to plan your treatment based on your insurance coverage.
Understanding the Cost of Sublocade With and Without Insurance
You will be required to cover the copay associated with your insurance. If you have commercial insurance, this could be anywhere from a couple of cents per dose to $1,900, depending on your coverage. The average is $402, according to the Sublocade website. People with Medicaid typically pay between $1 and $4 for their monthly Sublocade treatment.
If you’re not sure that you can afford to pay your copay, the INSUPPORT® Copay Assistance Program may be able to help you. If you qualify for the program, INSUPPORT® will cover up to the entire cost of your first two doses, and you will be eligible for reduced copays after that.
Without insurance, the cost of Sublocade is $2,117.34. However, most people will not pay this amount for the medication.
What to Do if You Don’t Have Insurance or It Does Not Cover Sublocade
If you don’t have insurance or your insurance doesn’t cover Sublocade, options are still available. If you choose ReVIDA® Recovery for MAT treatment, we have scholarships available to Tennessee residents who can’t afford to pay for treatment. In 2025, we began our Care for All program, which expanded scholarship options even further.
ReVIDA® will also partner you with a trained coordinator, who will help you come up with a payment plan.
You can also choose to use a different medication for treatment. If your insurance provider doesn’t cover Sublocade, they may cover another medication, like Suboxone.
Suboxone works similarly to Sublocade. Just like Sublocade, Suboxone also uses the active ingredient buprenorphine to treat the symptoms of opioid withdrawal.
There are two key differences between Suboxone and Sublocade. While Sublocade is administered monthly, Suboxone comes in the form of a daily tablet or film. In addition to the active ingredient of buprenorphine, Sublocade also contains naloxone.
Naloxone is commonly used to reverse the effects of an opioid overdose. Its presence in Suboxone is intended to prevent misuse. Although buprenorphine has a ceiling effect, naloxone serves as a second precautionary measure, ensuring that Suboxone doesn’t have any of the desired effects of opioids, even when it’s taken in extreme quantities.
Sublocade Treatment at ReVIDA® in Appalachia
Healing from opioid use disorder is never simple, but Sublocade treatment makes it easier. The medication makes it possible to focus on therapy and other life goals much more quickly than traditional withdrawal and has a lower rate of return to use.
Therapy is where the real work begins. You’ll work with your therapist to identify the relationship between your thoughts, feelings, and actions. Together, you’ll identify harmful thought patterns and unhealthy behaviors. Over time, you’ll find healthier coping mechanisms and deal with the root causes of your OUD.
ReVIDA® Recovery has many locations throughout Tennessee and Virginia. We are excited to be part of your team and commit to being there every step of the way. We’ll connect you with important resources, like housing, SNAP, and employment opportunities to support your recovery. We also offer flexible outpatient therapy so you have access to care while still keeping up with your busy schedule. If you have any questions or concerns or wish to begin treatment, please contact us at 423-631-0432 today.
ReVIDA® Recovery: Reclaim Your Life
