Thursday December 8th 2016

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Does health insurance cover Acamprosate?

Acamprosate is an effective treatment used in addressing alcohol dependency. While its mechanism of action is not understood, it is thought to decrease alcohol intake by affecting calcium channels and modifying transmission along GABA and glutamine pathways in the brain. The result? Decreased positive reinforcement of alcohol intake = decreased withdrawal cravings.

But how affordable is acamprosate? Is acamprosate covered by insurance? What types of cost sharing and insurance coverage are available? More on the price of acamprosate with and without insurance here. Then, we invite your questions about affordable use of acamprosate at the end. (We try to respond to all comments personally and promptly.)

Is acamprosate covered by insurance?

Yes.

Insurance often covers the treatment of alcohol use disorders with acamprosate. Acamprosate’s effectiveness has been studied and found to help alcoholics by reducing cravings for alcohol. So, this medication has been accepted by the mainstream health community as a viable treatment option for alcoholism, especially when combined with psychological and behavioral therapy.

For people whose insurance does not cover behavioral or mental health treatment plans, one available option is public insurance, which can make medication assisted treatment affordable, compared to such cases when no insurance is provided. For example, Medicare offers prescription drug coverage to everyone with Medicare. To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.

Acamprosate cost without insurance

The cost of acamprosate is around $170 per month if you don’t have a drug insurance plan. Talk to your doctor for more details about your therapy and find out the best way to order acamprosate. You might even check online for lower prices on this prescription drug.

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Acamprosate cost with insurance

There are two usual types of cost share programs insurance companies use to bill medications like acamprosate: preferred network pharmacies and mail order pharmacies. Most often, you’ll need to look out for the brand name of acamprosate when buying meds via insurance (Campral), which comes in packets of 180 tablets:

Preferred Network Pharmacies – This package includes a cost-share amount you pay during the initial coverage phase for a 30-Day supply (until your total retail prescription drug costs reaches a certain amount) at a approved pharmacy. In most cases, the “Preferred” network and network pharmacy pricing are the same.

Mail Order – This package includes the cost-share amount you would pay during the initial coverage phase for a 90-Day supply if you purchased your medication through your plan’s preferred mail order partner(s).

Acamprosate insurance coverage

Insurance firm’s revenue is based on end user benefit. Thus, they frequently make it a point to provide terms for partial or complete coverage of medication assisted treatments like acamprosate when they offer policies to individual clients or to employers. Because acamprosate works to treat alcohol dependence, it should be an approved prescription medication by your network.

When you need help figuring out how your addiction treatment is covered in your insurance policy or if you want to find a program that is wholly or partially covered by your insurance plan, you may contact the health insurance provider directly.

Medical insurance for Acamprosate questions

As always, we’re here to help. If you have any questions or concerns about acamprosate insurance coverage, feel free to leave them in the comments section below. We’l do our best to respond to you personally and promptly.

Reference Sources: SAMHSA: Medicaid Coverage and Financing of Medications to Treat Alcohol and Opioid Use Disorders
Canada CAMH: Medications for use in the treatment of substance use disorders
AAFP: Acamprosate for treatment of alcoholism
Medicare: How to get drug coverage

Photo credit: NLM Med Library

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