Medically reviewed by Stuart Wasser, MD, Medical Director • View Profile • Editorial process
Medication-Assisted Treatment (MAT)
Suboxone, Sublocade & Vivitrol in Nassau County.
Our MAT & Drug Rehab Program in Nassau County combines FDA-approved medications (Suboxone, Sublocade, and Vivitrol) with behavioral therapy to treat the "Whole Patient"—stabilizing your body so you can do the work to heal your mind.
Advanced Medical Solutions.
We prescribe and manage the latest medications to reduce cravings and withdrawal symptoms. Your treatment plan is customized by our board-certified medical director.
Suboxone
(Buprenorphine/Naloxone)
Daily oral film/tablet used to treat opioid addiction by reducing cravings and withdrawal.
Sublocade
(Buprenorphine ER)
Once-monthly injection that provides continuous release, eliminating daily dosing requirements.
Vivitrol
(Naltrexone)
Monthly injection that blocks opioid receptors and reduces alcohol cravings. Non-narcotic.
Brixadi
(Buprenorphine XR)
Weekly or monthly injection options allowing for flexible, personalized dosing schedules.
Does my insurance cover MAT like Suboxone, Sublocade and Vivitrol?
New York State has robust regulations promoting access to medication-assisted treatment (MAT) for opioid use disorder (OUD), including drugs like Suboxone (buprenorphine/naloxone), Sublocade (extended-release buprenorphine injection), and Vivitrol (extended-release naltrexone injection). These stem from mental health and substance use disorder (SUD) parity laws, which require SUD benefits to be provided on par with medical/surgical benefits in regulated plans, combined with specific MAT access protections.
Commercial Insurance (Fully Insured Plans)
Regulated by the NYS Department of Financial Services (DFS) under Insurance Law §§ 3216, 3221, and 4303, along with federal MHPAEA enhancements:
- If a plan includes prescription drug or outpatient benefits, insurers must cover evidence-based MAT for OUD without discriminatory barriers.
- Prior authorization is prohibited for preferred/formulary forms of buprenorphine (including Suboxone and generics) and long-acting injectable naltrexone (Vivitrol).
- Sublocade, as an extended-release buprenorphine, benefits from these protections but is often non-preferred due to higher cost and administration requirements, potentially allowing step therapy or exceptions.
- Plans can use formulary tiers, but overall SUD treatment cannot be more restrictive than medical/surgical care.
Medicaid (Fee-for-Service and Managed Care)
Governed by separate NYS Department of Health rules, including a single statewide MAT formulary:
- Broad mandatory coverage of MAT with no prior authorization required for most preferred agents when prescribed per guidelines.
- Explicitly includes Suboxone (often preferred with brand reimbursement incentives), Vivitrol, and Sublocade.
- Strongest universal protections—no utilization controls or lifetime limits for covered forms.
Medicare (Part B & Part D)
Medicare coverage works differently than NYS Commercial/Medicaid plans, with specific distinctions between provider-administered drugs (Part B) and pharmacy prescriptions (Part D).
- Part B: Covers office-based injectables like Sublocade and Vivitrol.
- Part D: Covers oral prescriptions like Suboxone (sublingual films/tablets).
Key Exemptions and Limitations
- Self-funded ERISA plans (common for large employers) → exempt from state mandates; only federal parity applies.
- Plans without outpatient prescription drug benefits → no requirement to cover oral/injectable MAT drugs.
- Out-of-state policies or federal programs (e.g., Medicare) → not subject to NYS rules.
- Even in covered plans, non-preferred drugs may require medical necessity review or exceptions.
Regulation Notes
These regulations aim to reduce barriers to lifesaving MAT, with the strongest mandates in Medicaid and fully insured commercial plans. Coverage is not guaranteed across every policy or for every brand/form, and federal parity provides a baseline floor. For individual cases, consult the insurer or NYS DFS/DOH. As of December 18, 2025, no major overhauls to these frameworks have occurred.
Infographic: NYS MAT Treatment Mandate Regulations
NYS Insurance Mandates Comparison
| Insurance Type | Regulated by NYS? | MAT Coverage Required? | Prior Auth Prohibited? | Key Exemptions | Specific Drugs Covered? |
|---|---|---|---|---|---|
| Fully Insured Commercial Plans (Individual, Small Group, Large Group issued in NY) | Yes (NYS DFS) | Yes, if plan includes prescription/outpatient benefits; SUD treatment at parity | Yes, for formulary buprenorphine and injectable naltrexone | Formulary tiers allowed; non-preferred may need exceptions | Generally yes Strongest protections for Suboxone/Vivitrol |
| Self-Funded ERISA Plans (Common in large employers) | No (Federal ERISA) | No state mandate; federal parity only | No state prohibition | Entirely exempt from NYS rules; coverage varies by employer plan | Varies No guaranteed coverage or PA protections |
| Medicaid (FFS & Managed Care) | Yes (NYS DOH) | Yes, broad MAT required via single statewide formulary | Generally No (for preferred) | Single MAT formulary; quantity limits possible | Yes, all three explicitly covered |
| Medicare | No (Federal) | Varies by Part D plan | Varies federally | No NYS mandates apply | Often covered, but plan-specific |
| Out-of-State Plans (Covering NY residents) | No | No | No | Exempt if policy issued elsewhere | No NYS protections |
| Plans Without Drug Benefits | Partial | No for outpatient drugs | N/A | Can exclude prescription drugs entirely | No requirement for outpatient MAT drugs |
Note: While NYS mandates are strong, individual plan specifics can vary. Always verify coverage directly with your insurer or our admissions team.
Suboxone Treatment: Common Questions
Specifics on dosing, withdrawal, and what to expect.
Sublocade Injection Support
Monthly buprenorphine injections.
Vivitrol (Naltrexone) Questions
Monthly non-opioid injection for alcohol and opioid addiction.
Brixadi Treatment Options
Weekly and monthly buprenorphine injections.
General MAT Questions
Broad information about our medication-assisted treatment program.
Ready to Start Your Recovery?
Call us today to schedule your intake. Our compassionate team is here to help you take the first step toward recovery.
Proudly Serving Nassau County Communities
Integrity Treatment Partners provides outpatient addiction treatment and mental health services to residents throughout Nassau County and surrounding areas. We proudly serve the following communities from our centrally located facility in Baldwin, NY: