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Medicaid Behavioral Health Services: Naloxone Coverage Provided for Family Members or Friends Obtaining a Naloxone Prescription on Enrollee’s Behalf
This data is presented as an interactive tool that allows users to: filter by timeframe/year, select specific data columns (distributions), filter by state or geography, and view the data as a table, map, or trend chart.
2022
Location
Service Covered?
Copayment Required?
Limits on Services?
United States
Yes - 25; No - 20; NR - 6
Yes - 5
Yes - 4
Alabama
No
Alaska
Yes
NR
NR
Arizona
Yes
$4 for some members
No
Arkansas
NR
NR
NR
California
No
Colorado
Yes
$3
No
Connecticut
Yes
No
No
Delaware
NR
NR
NR
District of Columbia
No
Florida
No
Georgia
NR
NR
NR
Hawaii
Yes
No
No
Idaho
Yes
No
Limit of 3 per day
Illinois
Yes
NR
NR
Indiana
Yes
$4 copay for generics and $8 copay for brand name
No
Iowa
No
Kansas
No
Kentucky
Yes
No
NR
Louisiana
No
Maine
No
Maryland
No
Massachusetts
Yes
No
No
Michigan
Yes
No
No
Minnesota
NR
NR
NR
Mississippi
Yes
$3
Yes - not specified
Missouri
No
Montana
Yes
No
No
Nebraska
No
Nevada
Yes
No
NR
New Hampshire
NR
NR
NR
New Jersey
Yes
No
No
New Mexico
No
New York
Yes
No
No
North Carolina
Yes
$4
NR
North Dakota
Yes
No
No
Ohio
Yes
No
No
Oklahoma
Yes
NR
NR
Oregon
No
Pennsylvania
Yes
No
No
Rhode Island
Yes
No
No
South Carolina
No
South Dakota
No
Tennessee
No
Texas
Yes
No
Family members and friends may pick up prescriptions for enrollees in need of naloxone but only Medicaid enrollees are provided coverage for naloxone (Medicaid reimburses pharmacy)
Utah
NR
NR
NR
Vermont
No
Virginia
No
Washington
Yes
No
No
West Virginia
Yes
No
Based on medical necessity
Wisconsin
No
Wyoming
No
2018
Location
Service Covered?
Copayment Required?
Limits on Services?
United States
Yes - 19 No - 25 NR - 7
Yes - 8
Yes - 4
Alabama
No
Alaska
No
Arizona
Yes
$2.30 per prescription for beneficiaries with Transitional Medical Assistance
No
Arkansas
No
California
No
Colorado
Yes
$3 per prescription or refill
Each drug may be subject to utilization controls per the Preferred Drug List or Appendix P criteria.
Connecticut
No
Delaware
No
District of Columbia
Yes
$1.00/Rx for point of sale drugs only
No
Florida
Yes
No
The family member or friend would need to have the recipient's ID number in order to bill for service.
Georgia
Yes
$.50 to $3.00
No
Hawaii
Yes
No
No
Idaho
Yes
No
NR
Illinois
NR
NR
NR
Indiana
Yes
$3 per prescription
NR
Iowa
NR
NR
NR
Kansas
No
Kentucky
No
Louisiana
No
Maine
No
Maryland
No
Massachusetts
Yes
No
No
Michigan
Yes
No
No
Minnesota
Yes
Minnesota assesses a $3 copay for non-preferred drugs, and $1 copay for preferred drugs. Copays are limited to $12 per month. No copays are assessed for certain mental health drugs.
NR
Mississippi
No
Missouri
No
Montana
Yes
No
No
Nebraska
No
Nevada
Yes
No
No
New Hampshire
Yes
zero, $1.00 and $2.00 dependent upon multiple factors: FPL, drug, if waiver recipient and preferred drug status
No
New Jersey
No
New Mexico
No
New York
NR
NR
NR
North Carolina
NR
NR
NR
North Dakota
Yes
$3 per prescription fill for brand names only
No
Ohio
Yes
No
No
Oklahoma
Yes
No
Service is provided through HSI-CHIP program.
Oregon
Yes
No
No
Pennsylvania
No
Rhode Island
No
South Carolina
NR
NR
NR
South Dakota
NR
NR
NR
Tennessee
No
Texas
Yes
No
Family members and friends may pick up prescriptions for enrollees in need of naloxone, but only medicaid enrollees are provided coverage (Medicaid reimburses pharmacy) for naloxone.