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Naloxone

Does my health insurance provide coverage for naloxone?

Consumers who have individual or group health insurance that provides coverage for prescription drugs also have coverage for at least one opioid antagonist, which may include naloxone. Please contact your health insurance plan to learn more about your options and coverage.

 

How much will I pay if my insurance provides coverage for naloxone?

Consumers with individual or group health insurance that provides coverage for naloxone usually are able to receive naloxone free of charge from any network or participating pharmacy regardless of whether you have a prescription or not. However, if you have a High Deductible Health Plan (HDHP), also known as an HSA-eligible plan, you will still need to pay for naloxone until you reach the applicable deductible.

Your health plan may require cost sharing, such as a co-pay or co-insurance, for other opioid antagonists.

If you encounter problems receiving opioid antagonist or naloxone benefits, you may file a complaint with the Office of Consumer Health Insurance at the Illinois Department of Insurance (IDOI) by visiting the  IDOI website and IDOI Help Center or calling 877-527-9431 to request that a complaint form be mailed to you.

For more naloxone informational materials, please visit the Illinois Department of Human Services website.

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