Paying for medication treatment

Does Medicaid cover Suboxone and MAT?

Yes. Federal law requires every state Medicaid program to cover all FDA-approved medicines for opioid use disorder: buprenorphine (Suboxone and generics), methadone and naltrexone (Vivitrol), plus the counseling that goes with them. States can still use a preferred drug list, prior authorization and dose limits. Here's what we could confirm for Texas, Louisiana, Oklahoma, Arkansas, Missouri, Kansas and Mississippi, and what to do if you don't have Medicaid.

By Ryan Coane, LCDC-I. Updated October 27, 2026. General information, not medical or insurance advice: drug lists change, so check with your health plan, and talk with a doctor or other prescriber about your treatment.

Help right now: if someone is very sleepy, can't be woken, or is breathing slowly or not at all, call 911 and give naloxone (Narcan) if you have it. In a mental health or substance use crisis, call or text 988, any time. SAMHSA's National Helpline, 1-800-662-4357, is free, confidential and open 24/7 for treatment referrals, including for people without insurance.

The short answer

Medicaid covers all three medicines for opioid use disorder in every state, by federal law, since October 1, 2020. Congress made that permanent in 2024.
The details differ by state: which brands are "preferred," whether your prescriber has to get prior authorization, and how high a dose is allowed.
Which brand is "preferred" differs: some states prefer generic buprenorphine-naloxone, others prefer brand-name Suboxone film. Ask the pharmacist which one goes through on your plan.
Methadone is covered at opioid treatment programs (methadone clinics) that take Medicaid. Ask the clinic before your first visit.
No Medicaid? Every state has public money for people who can't pay. Start with SAMHSA's helpline or your state's agency, listed below.

What federal law requires

Section 1006(b) of the SUPPORT for Patients and Communities Act (2018) made medication-assisted treatment a required Medicaid benefit starting October 1, 2020. CMS told states the benefit covers "all drugs approved" by the FDA to treat opioid use disorder, "including methadone," and the counseling and behavioral therapy that go with them. The original law was set to end in 2025; section 201 of the Consolidated Appropriations Act, 2024 made it permanent.

The same CMS guidance says states may still use preferred drug lists, prior authorization and similar limits. That's why coverage looks different from state to state.

Prior authorization, in plain words

Prior authorization (PA) means your prescriber has to get the plan's approval before the pharmacy can fill a prescription. It usually comes up for a non-preferred brand, a dose above the plan's limit, or a long-acting shot. If the pharmacy says a prescription "needs a PA":

Call your prescriber's office and ask them to send the PA today, or switch to a preferred product.
Ask the pharmacist which version is preferred on your plan. Often a generic film or tablet goes through right away.
Call the member services number on your Medicaid card if it's stuck. Ask how long a decision takes and how to appeal a denial.

State by state

What we could confirm from each state's own drug list and rules, checked in October 2026, and where we couldn't. All seven states filed updated Medicaid plan pages in 2025 and 2026 promising coverage of buprenorphine, methadone and naltrexone. "KFF 2022" means a survey of state Medicaid programs as of July 1, 2022. Drug lists change, usually twice a year, so confirm with your plan or pharmacy.

State and program	Buprenorphine (Suboxone)	Methadone at a clinic	Naltrexone (Vivitrol)
Texas Medicaid	Covered; all forms on the list are preferred, with a safety check	Covered at licensed clinics	Covered; Vivitrol preferred
Healthy Louisiana	Generic films and tablets, Zubsolv, Sublocade and Brixadi preferred; brand Suboxone needs PA	Covered since 2020	Covered; Vivitrol preferred
SoonerCare	Generic tablets preferred; films (brand or generic) and Zubsolv need PA	Covered	Vivitrol covered with no PA
Arkansas Medicaid	Suboxone film, Zubsolv and buprenorphine tablets preferred with no PA; generic buprenorphine-naloxone non-preferred	Covered under the state plan; ask the clinic if it bills Medicaid	Covered; tablets and Vivitrol preferred
MO HealthNet	Suboxone film, generic tablets, Sublocade and Brixadi preferred; generic films and Zubsolv non-preferred	Covered	Covered; tablets and Vivitrol preferred
KanCare	Covered; current preferred products and PA rules not confirmed	Covered (KFF 2022)	Covered (KFF 2022)
Mississippi Medicaid	Covered; current preferred products and PA rules not confirmed	Covered since October 1, 2020	Covered (KFF 2022)

Texas: Texas Medicaid

Drug list. Texas Medicaid and all its managed care plans (STAR, STAR+PLUS and others) follow one preferred drug list. On the list effective January 1, 2026, every drug in "opiate dependence treatments" is preferred: generic buprenorphine-naloxone, Suboxone film, Zubsolv, buprenorphine, naltrexone and Vivitrol.
Safety check. Texas still applies a clinical prior authorization to buprenorphine. The state's criteria look for an opioid use disorder diagnosis and check for recent prescriptions for opioid pain medicine. Buprenorphine without naloxone is generally for pregnancy or another documented reason. If a claim is rejected, the prescriber's office can sort it out.
Methadone. Covered at licensed opioid treatment programs; take-home doses are limited to 30 per 30 days.
Check: search any drug in the Texas Medicaid formulary, or call the member number on your plan card.

Louisiana: Healthy Louisiana

Drug list. One preferred drug list covers fee-for-service Medicaid and every Healthy Louisiana plan. On the list effective July 1, 2026 (updated October 23, 2026), these are preferred: generic buprenorphine-naloxone films and tablets, Zubsolv, generic buprenorphine tablets, the Sublocade and Brixadi shots, Vivitrol and naltrexone tablets. Brand-name Suboxone film is non-preferred and needs prior authorization, so ask for the generic.
Pharmacy edits. The list notes that extra point-of-sale checks may apply, such as dose limits.
Methadone. Covered at opioid treatment programs since 2020 (state plan amendment LA 19-0030).

Oklahoma: SoonerCare

Preferred. The Oklahoma Health Care Authority's 2026 criteria say generic buprenorphine-naloxone tablets and buprenorphine tablets are the preferred products. Films (brand Suboxone or generic) and Zubsolv need prior authorization with a reason the tablets won't work.
Vivitrol is covered without prior authorization. Sublocade needs prior authorization, and new starts must explain why Brixadi won't work.
Doses above 24 mg of buprenorphine a day are reviewed case by case. Prescriptions are denied if you're also getting opioid pain medicine.
Methadone. Covered at opioid treatment programs (Oklahoma Administrative Code 317:30-5-241.7).

Arkansas: Arkansas Medicaid

No prior authorization for preferred medicines. After Arkansas's Act 964 of 2019, CMS approved a plan change removing prior authorization for medication-assisted treatment, effective August 1, 2020.
Preferred (state memo for October 1, 2026): Suboxone film (brand), Zubsolv, buprenorphine tablets and naltrexone tablets; the Brixadi, Sublocade and Vivitrol shots are also preferred. Generic buprenorphine-naloxone films and tablets are non-preferred. The daily limit is the equivalent of 32 mg of buprenorphine.
Methadone. Arkansas's state plan, approved by CMS on March 26, 2026, assures coverage of methadone through opioid treatment programs. We couldn't confirm how many clinics bill Arkansas Medicaid, so ask the clinic before your first visit.

Missouri: MO HealthNet

State law. RSMo 191.1165 requires MO HealthNet to cover medication-assisted treatment medicines and to put all FDA-approved forms on its preferred drug list.
Drug list. Pharmacy benefits for all MO HealthNet members, including those in health plans, run through the state. On the list revised April 2, 2026, preferred: Suboxone film, generic buprenorphine and buprenorphine-naloxone tablets, Sublocade, Brixadi, naltrexone tablets and Vivitrol. Non-preferred: generic buprenorphine-naloxone film and Zubsolv. Up to 32 mg of buprenorphine a day is approved automatically.
Methadone. Covered at opioid treatment programs (KFF 2022 and the state plan).

Kansas: KanCare

Plans. KanCare has three health plans through 2027: Sunflower, UnitedHealthcare and Healthy Blue. They use the state's preferred drug list from the Kansas Department of Health and Environment, and Kansas's plan allows generic-first rules, clinical criteria, quantity limits and daily dose limits for these medicines.
Methadone and naltrexone. Covered, with no limits reported (KFF 2022).
Not confirmed: which buprenorphine products are preferred right now and which need prior authorization; the state's site blocked our checks. See the KDHE preferred drug list or call your KanCare plan.

Mississippi: Mississippi Medicaid

Methadone. Since October 1, 2020, Mississippi Medicaid has paid opioid treatment programs for medication-assisted treatment, including methadone (state plan amendments 20-0023 and 22-0020). KFF's 2022 survey reported prior authorization for the weekly bundled clinic code.
Plans. All Mississippi Medicaid health plans (MississippiCAN: Magnolia, Molina and TrueCare) follow the state's preferred drug list.
Not confirmed: which buprenorphine products are preferred right now and which need prior authorization; we couldn't open the current list. Check the Division of Medicaid's pharmacy and preferred drug list pages or call your plan.

No Medicaid or insurance?

First, see if you qualify for Medicaid. Louisiana, Oklahoma, Arkansas and Missouri have expanded Medicaid to more low-income adults. Texas, Kansas and Mississippi haven't, so many adults there, especially those without children, don't qualify. If you're in Texas, see how to apply for Texas Medicaid.

Then use state-funded treatment. Every state gets a federal block grant from SAMHSA to pay for substance use treatment for people who can't afford it. Your state's agency can connect you:

Texas: HHSC's OSAR program (Outreach, Screening, Assessment and Referral). Dial 2-1-1 and ask for OSAR.
Louisiana: the Office of Behavioral Health, which works through regional local governing entities.
Oklahoma: the Department of Mental Health and Substance Abuse Services.
Arkansas: the Department of Human Services' Office of Substance Abuse and Mental Health, which funds treatment for people without insurance.
Missouri: the Department of Mental Health, Division of Behavioral Health.
Kansas: the Kansas Department for Aging and Disability Services (KDADS), behavioral health services.
Mississippi: the Department of Mental Health and its community mental health centers.

Other low-cost options:

Community health centers charge on a sliding scale by income, and many prescribe buprenorphine. Find a health center.
On FindTreatment.gov, filter for "sliding fee scale" or "payment assistance."
Generic buprenorphine-naloxone costs much less than brand-name Suboxone. Compare cash prices at a few pharmacies.
Read more in Does insurance cover rehab?

Find a program that takes Medicaid

Programs offering medication for addiction on Cima Find Care, with phone numbers. Each listing shows the insurance it accepts; call to confirm it takes your plan.

Texas: Houston, Dallas, San Antonio, Austin, El Paso
Louisiana: New Orleans, Baton Rouge
Oklahoma: Oklahoma City, Tulsa
Arkansas: Little Rock
Missouri: St. Louis, Kansas City
Kansas: Wichita
Mississippi: Jackson

Questions people ask

Does Medicaid pay for Suboxone?

Yes. Federal law has required every state Medicaid program to cover FDA-approved medicines for opioid use disorder, including buprenorphine-naloxone, since October 1, 2020. Your plan may prefer a generic or require prior authorization for some forms or doses.

Does Medicaid cover methadone clinics?

The federal requirement includes methadone given at opioid treatment programs. All seven of our states' Medicaid plans promise it. Not every clinic takes Medicaid, so ask the clinic whether it bills your plan.

Is Sublocade covered by Medicaid?

Long-acting buprenorphine shots are FDA-approved for opioid use disorder, so Medicaid must cover them, but they often need prior authorization and are given at a clinic. Ask your prescriber to check with your plan.

Will Medicaid cover counseling too?

Yes. The federal benefit includes counseling and behavioral therapy given along with the medicine.

What if I'm on Medicare?

Medicare Part B covers methadone, buprenorphine and naltrexone given through an enrolled opioid treatment program, with no copay there (the Part B deductible applies). If you have both Medicare and Medicaid, Medicaid can pick up what Medicare doesn't.

Sources

CMS, State Health Official Letter #20-005, Mandatory Medicaid State Plan Coverage of Medication-Assisted Treatment (SUPPORT Act section 1006(b); covers all FDA-approved drugs "including methadone"; states may use utilization management): medicaid.gov
CMS, State Medicaid Director Letter #24-004, permanent extension of the mandatory MAT benefit (Consolidated Appropriations Act, 2024, section 201): medicaid.gov
KFF, Medicaid Behavioral Health Services (2022 survey, as of July 1, 2022): methadone, oral buprenorphine, injectable buprenorphine, injectable naltrexone
Texas HHSC Vendor Drug Program, Preferred Drug List effective January 1, 2026 (opiate dependence treatments) and the preferred drugs page: txvendordrug.com
Louisiana Medicaid Preferred Drug List, effective July 1, 2026 (updated October 23, 2026): ldh.la.gov; state plan amendment LA 19-0030 (OTP coverage): medicaid.gov
Oklahoma Health Care Authority, 2026 prior authorization criteria, Central Nervous System/Behavioral Health (Medication Assisted Treatments): oklahoma.gov; OHCA, Medication assisted treatment services (OAC 317:30-5-241.7): oklahoma.gov
CMS approval of Arkansas State Plan Amendment 20-0013, removing prior authorization for medication-assisted treatment, effective August 1, 2020: medicaid.gov; CMS approval of Arkansas SPA 25-0015 (March 26, 2026), assuring coverage of methadone through OTPs: medicaid.gov; Arkansas DHS DUR provider memo, PDL update effective October 1, 2026: primetherapeutics.com; AMA on Arkansas Act 964 (2019): ama-assn.org
Revised Statutes of Missouri section 191.1165 (MAT medications; MO HealthNet preferred drug list): revisor.mo.gov
MO HealthNet, Opioid and Select Alcohol Dependence Agents PDL edit (revised April 2, 2026): mydss.mo.gov
Texas HHSC, buprenorphine agents clinical prior authorization criteria (October 1, 2025): acentra.com; CMS approval of Texas SPA 25-0038 (MAT): medicaid.gov
KDHE, KanCare managed care organization contracts (bulletin 24118): kmap-state-ks.us; CMS approval of Kansas SPA 25-0024: medicaid.gov
Kansas Department of Health and Environment, Preferred Drug List and PA criteria: kdhe.ks.gov
Mississippi Division of Medicaid, State Plan Amendment 20-0023, Medication Assisted Treatment (approved pages): medicaid.ms.gov
CMS approval of Mississippi SPA 22-0020 (OTP payment since October 1, 2020): medicaid.gov; Mississippi Division of Medicaid, managed care: medicaid.ms.gov
KFF, Status of State Medicaid Expansion Decisions (October 2026): kff.org
SAMHSA, Substance Use Prevention, Treatment, and Recovery Services Block Grant: samhsa.gov
Medicare.gov, Opioid use disorder treatment services: medicare.gov