How Much Does Sublocade Cost? How to Pay for Treatment.

If you’ve ever tried to stop taking opioids on your own, you know how difficult a process that can be. Medication-assisted treatment (MAT) options, like Sublocade, can make that easier.

Whenever you’re considering starting a new course of treatment, it’s normal to have questions like, “How much does Sublocade cost?” The exact amount you’ll pay for Sublocade varies depending on many factors, including your insurance coverage and where you receive your treatment.

If you’re ready to take a buprenorphine-based medication to treat opioid use disorder (OUD), you’re not alone. In 2023, the buprenorphine dispensing rate was over 10 out of every 100 people in Tennessee, according to the Centers for Disease Control.

At ReVIDA® Recovery, we believe that everyone should be able to afford the treatment they need. That’s why we will always provide scholarship options and payment plans whenever possible.

Key Takeaways

• In many cases, Sublocade to treat opioid use disorder is covered by commercial insurance, Medicaid, and Medicare.
• The best way to determine the cost of Sublocade with commercial insurance is to contact your provider.
• People with Medicaid pay an average of $3 a month for Sublocade treatment.
• Individuals on Medicare pay an average of $97 out of pocket for Sublocade.
• Without insurance, the list price of Sublocade is $2,117.34 per dose, but support options are available.

Understanding Treatment: What is Sublocade?

Sublocade is an extended-release, buprenorphine-based medication used to treat opioid use disorder. The medication takes the form of a shot administered once a month by a doctor.

Although Sublocade starts out as a liquid, it takes the form of a gel once it enters your bloodstream. It forms a small gel pocket, called a depot, and lets a steady amount of buprenorphine into your body as it depletes throughout the month.

Buprenorphine is a partial opioid agonist, meaning it attaches itself to opioid receptors the same way traditional opioids would, but without the same intensity. This is the active ingredient that makes Sublocade effective.

The medication also has a “ceiling effect,” meaning that you don’t feel the desired effects of opioids, regardless of the quantity of your dose. Sublocade also prevents you from feeling the full effects of other opioids if you take them during treatment.

Sublocade is designed to limit the extent of your cravings for opioids and reduce the intensity of other withdrawal symptoms to support your recovery. You don’t have to stay on Sublocade indefinitely. You’ll work with your doctor to decide how long you need to stay on the medication and determine the safest way for you to end medication-assisted treatment (MAT).

What Are the Benefits of Sublocade?

The Sublocade shot offers many benefits. Most importantly, the medication minimizes any withdrawal symptoms you may experience when going off opioids after taking them for an extended period of time. This applies to both acute and post-acute withdrawal symptoms.

What Acute Withdrawal Symptoms Does Sublocade Treat?

The symptoms of acute opioid withdrawal mimic the symptoms you would usually associate with the flu or a bad cold. Since the active ingredient in Sublocade binds to your opioid receptors, these symptoms won’t be as severe as they would be without MAT.

Common symptoms of acute opioid withdrawal include:

• Runny nose
• Watery eyes
• Agitation
• Anxiety
• Dilated (large) pupils
• Aching muscles
• Intense sweating
• Excessive yawning
• Insomnia or trouble sleeping

How Does Sublocade Treat Post-Acute Withdrawals?

While acute opioid withdrawal symptoms are more physical in nature, the symptoms of post-acute withdrawal syndrome (PAWS) are typically more psychological. These symptoms can occur weeks or months after you’ve ended your opioid consumption. The severity of these symptoms is lessened by taking Sublocade.

6 symptoms associated with PAWS are:

1. Intense mood swings
2. Impulse control issues
3. Aggression, or hostility
4. High sensitivity to stress
5. Brain fog or trouble thinking things through
6. Anxiety or depression

What To Know About Paying For Sublocade

Whether you’re just starting treatment for OUD or you’ve been in recovery for a while and are exploring new treatment options, the cost of medication is always important to be aware of.

When it comes to paying for Sublocade, there are a few different things you need to consider, including:

• Does your insurance provider cover Sublocade?
• What would your copay be?
• How would you pay for treatment without insurance coverage?
• Does the MAT provider I’m working with take my insurance?
• What alternatives are available?

These are important questions to ask as you’re getting ready to start a new treatment plan utilizing Sublocade. Doing research on your individual insurance plan and goals for treatment is a vital step in the process.

Understanding Costs and Insurance Coverage of Sublocade

The factor that has the biggest impact on how much you’ll pay for Sublocade is your insurance plan. The price will vary depending on the specific treatment plan you have. In this section, we’ll examine the different kinds of insurance that cover Sublocade.

Does Commercial Insurance Cover Sublocade?

In most cases, Sublocade is covered by insurance. The best way to learn more about the coverage provided by your plan is to call the number on the back of your insurance card and speak with a representative.

The MAT clinic where you receive your Sublocade shot could also impact your coverage. At ReVIDA® Recovery, we work with most major insurance companies.

At our Tennessee locations, we work with:

• Blue Cross Blue Shield of Tennessee
• UnitedHealthcare
• Amerigroup
• Medicare
• Humana Behavioral Health Care
• Aetna
• Ambetter of Tennessee
• Cigna Healthcare Evernorth
• Farm Bureau Insurance

Our Virginia locations’ insurance options are a bit different but include:

• Aetna
• Anthem Blue Cross Blue Shield
• Optima Health
• Virginia Premier
• Magellan Healthcare
• Molina Healthcare
• UnitedHealthcare
• Medicare
• Humana Behavioral Healthcare
• Cigna Healthcare Evernorth

If you work with a different MAT provider, the insurance plans they accept may be different.

When working with an insurance provider, you will still be responsible for your copays. If you’re unsure whether or not you can afford the cost of 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. According to the Sublocade website, 95% of people enrolled in the Commercial Copay Assistance Program pay $0 out of pocket.

What Is the Cost of Sublocade with Medicaid?

Typically, Sublocade is covered by Medicaid when used to treat OUD. On average, people on Medicaid pay about $3 a month for treatment, but some people pay as little as $1.

Medicaid programs vary a little bit depending on your state.

• In Tennessee, Medicaid is known as TennCare.
• In Virginia, Medicaid is called Cardinal Care.

Regardless of the state you’re located in, Medicaid 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 find out more about qualifying for Medicaid in your state, visit the TennCare or Cardinal Care websites, respectively.

What Is the Cost of Sublocade with Medicare?

People with Medicare pay between $0.02 and $1,607 for Sublocade treatment. On average, the out-of-pocket cost of Sublocade for people with Medicare is $97.

If you have a Medicare Part B plan, you could have a supplemental insurance plan that covers more of your costs of treatment. If you have Medicare Part C, you may have an out-of-pocket maximum that limits what you’ll be required to pay for Sublocade.

Finding Support to Help Cover the Cost of Sublocade

Without insurance, the cost of Sublocade is $2,117.34. In reality, the majority of people will not pay this amount for the medication.

If you receive MAT treatment at ReVIDA® Recovery, 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 allows us to provide even more scholarship opportunities.

ReVIDA® will also pair you with a care coordinator, whose job it is to help you come up with a payment plan.