Need help with opioids but worried about the bill? Good news: MaineCare—Maine’s Medicaid program—does pay for Medication-Assisted Treatment (MAT). Below is a no-nonsense look at what’s covered, when paperwork is needed, and how ENSO Recovery can make the process easy.
1. What “Medication-Assisted Treatment” Means
MAT pairs FDA-approved medicine with counseling:
| Medicine | What it does | Common Brand |
|---|---|---|
| Buprenorphine / naloxone | Cuts cravings, eases withdrawals | Suboxone (films or tabs) |
| Extended-release naltrexone | Blocks the “high” for 30 days | Vivitrol (monthly shot) |
You also meet with doctors or counselors to learn new coping skills.
2. What MaineCare Covers
MaineCare pays for:
- The medicines above (usually with a $0–$4 copay).
- Your first doctor visit and regular check-ups.
- Lab tests and urine screens.
- One-on-one or group counseling.
- Case management to keep all the pieces together.
In short: the whole package, not just the pills.
3. When Paperwork (Prior Authorization) Pops Up
Most people never notice a “PA,” but it can happen if:
- Your buprenorphine dose is higher than 24 mg a day.
- You ask for a pricey brand when a generic is available.
- Your doctor orders a medicine that is not on MaineCare’s “preferred” list.
Your clinic fills out a short form. MaineCare usually answers within three days, faster for emergencies.
4. How to Check Your Own Benefits
- Call MaineCare Member Services: 866-796-2463.
- Or log in to the online portal printed on your card.
- Ask:
- “Do I have coverage for opioid treatment or Suboxone?”
- “Any copays or prior authorizations I should know about?”
Also be sure your clinic is enrolled with MaineCare so they can bill directly.
5. How ENSO Recovery Helps
Two locations take MaineCare:
What we do for you:
- Verify your MaineCare the day you call.
- File any prior-auth forms.
- Set up counseling, Intensive Outpatient (IOP), and—if you need it—MAT-friendly sober housing.
- Fight denials or appeals so treatment doesn’t stop.
6. If MaineCare Says “No”
- You and your doctor can appeal. Many denials get overturned.
- During an appeal you often can keep getting your meds.
- No MaineCare? We offer sliding-scale fees and help with Marketplace plans.
7. Ready to Start?
Addiction can’t wait for paperwork. Call ENSO Recovery at 207-245-1800. We’ll check your MaineCare, handle the forms, and get you on medication that same week—sometimes the same day.
Recovery is possible. Cost shouldn’t stop you. Let’s get started.
