Suboxone, Insurance, and Doctor-Patient Confidentiality

[secretgoggles]

Hi. I'm 24/F. I want to visit a doctor for suboxone treatment because I've developed an opiate addiction.

I want to use my insurance for the visit and the medication while keeping this matter private. My mother is the policy holder for our insurance policy. Will she find out or be notified that I've visited a doctor for a substance abuse problem or been prescribed suboxone?

I spoke to the receptionist and she informed me that the policy holder will be notified(Maybe she thought I was a minor?)

Also will it affect the insurance policy in any way?

Thanks!

[secretgoggles]

Thanks for the response Dr. Junig. I might try to ask the doctor to diagnose me with pain and see what happens; too bad you're not in my area. If you know anyone that would do that for me and take my insurance I'd appreciate it if you'd let me know.

Also, do you know if the statement that goes out to the policy holder goes into detail about diagnosis, treatment, etc.?

[J T Junig, MD PhD]

I'm coming....

I take insurance for my Suboxone practice, and I don't know anyone who doesn't take insurance for it!  I don't accept the insurance as 'full payment', but I don't accept it for any psychiatric condition or diagnosis-- mainly because I don't want to do what many practices do, which is make it up 'in volume'.  I prefer to see at most two patients per hour (even for med checks) and refuse to join panels.  But I submit claims for people, and most of the time the insurer pays at least a good portion of the bill.  I am not advertising for new patients for Suboxone though, as I have been at the limit for a number of months.

As an aside, I hate modern psychiatry...  and I am repeatedly validated for my practice style, when a patient admits to me her eating disorder, that was not 'uncovered' by her prior three psychiatrists.  There are many things in psychiatry that will never come out in the span of ten minutes. Yes, it costs an extra 20-50 dollars to see me-- up to $200 over the course of a year--  but patients just do so much better when seen for thirty minutes than when seen for ten minutes.

Sorry for the commercial interruption...  Eagle's point about chronic pain is valid, if not a bit morally problematic.  I have done well since treatment almost nine years ago.  I recently applied for health insurance in Wisconsin... and was denied by everyone.  Nada.  nine years of being clean, but no luck.  Same for life and disability insurance.  So if you are in the 'system' as having opiate dependence, despite HIPPA,  the insurers will have ways to find out.  That stinks... but it is the way it is.  More and more, Suboxone is used to treat chronic pain;  Eagle is suggesting (I think) that if you started pain pills for... pain... you could consider asking the clinic to make THAT your primary diagnosis.  I would certainly do that for you.  For some reason, having low back pain is not seen as 'risky' as it is to be a recovering addict.

I don't think the policy holder is always told, but there is a statement that will go to the policyhoder each month or quarter that explains payouts and benefits.  If you go through insurance, I see no way to avoid that.

Rates for Suboxone vary widely;  I do the induction in the office, and the first appointment takes several hours, and costs $350...  the local hospital charges about ten times times that amount, and keeps people overnight, which is a bit of 'overkill' in my opinion.

I am glad that you are seeking treatment.  We are learning more and more about treating with Suboxone every day.

[secretgoggles]

Does anyone else have any answers?

Maybe I should post this in medical support communities?

[secretgoggles]

I called around, and w/o insurance, the whole thing would cost about $440-$480 with visits + meds. To much for me...

I was able to find a doctor who does take insurance for sub maintenance/detox therapy though.

To theeagle:

Thanks for responding. Could you explain further?

I don't have chronic pain so I wouldn't be able to do that. I need it for opiate withdrawal...

What do you mean by coding and how does that affect the insurance policy? What information is released? Do you know if the policy holder is informed of the reason for the visit, prescription, etc.? I don't live at home with my mother if that makes a difference...

I want to avoid embarrassing myself/hurting my family.

Thanks!

[122 Tactical Fighter Group]

If you have any valid means of approaching a Doc and obtaining a RX for sub for chronic pain it will not have an affect on anything - - its coded differently for insurance.

[liscamdave]

I don't know to be honest, I do know most drs do not take insurance for sub. you have to look around.