What are opioids?

An opioid is a type of drug that is used for pain. They may be prescriptions such as Oxycontin®, or they may be street drugs such as heroin.

They are extremely addictive.

What can I do for my pain instead of taking opioids?

GlobalHealth helps pay for other non-opioid medications for pain management.

Click here for your Drug Formulary.

GlobalHealth plans also include benefits for physical therapy and chiropractic services.

See your plan materials.

• Click here for Medicare Advantage.

What if I have a chronic pain condition that requires opioids?

If your doctor prescribes an opioid for you, it should be for the smallest dosage and the shortest time clinically appropriate.

However, if you have chronic pain and your doctor determines that an opioid is the most appropriate course of treatment for you, be sure you follow all directions your doctor gives you. Only take as directed.

If you are pregnant and are on opioids, talk to your doctor right away about your options. Not only are you taking them, but so is your baby.

Be sure to talk to your doctor about what to do in case of an accidental overdose. GlobalHealth covers medications designed to rapidly reverse opioid overdose, some at no cost to you.

• Get a prescription for naloxone or a naltrexone kit.
• Make sure your family/friends know the signs of an overdose.
• Make sure your family/friends know where the naloxone or naltrexone kit is located. Talk to your doctor about teaching them how to use it in an emergency,
• Make sure your family/friends know to call 911 immediately as well if you do need to use it.

If you are a Generations Medicare Advantage member, GlobalHealth can help you manage your opioid medications. 

We have a program that can help make sure our members safely use their prescription opioid
medications, or other medications that are frequently abused.

This program is called a Drug Management Program (DMP).

If you use opioid medications that you get from several doctors or pharmacies, we may talk to your doctors to make sure your use is appropriate and medically necessary. Working with your doctors, if we decide you are at risk for misusing or abusing your opioid or benzodiazepine medications, we may limit how you can get those medications.

The limitations may be:

• Requiring you to get all your prescriptions for opioid or benzodiazepine medications
  from one pharmacy
• Requiring you to get all your prescriptions for opioid or benzodiazepine medications
  from one doctor
• Limiting the amount of opioid or benzodiazepine medications we will cover for you

If we decide that one or more of these limitations should apply to you, we will send you a letter
in advance. The letter will have information explaining the terms of the limitations we think
should apply to you. You will also have an opportunity to tell us which doctors or pharmacies
you prefer to use. If you think we made a mistake or you disagree with our determination that
you are at-risk for prescription drug abuse or the limitation, you and your prescriber have the
right to ask us for an appeal.

Click here for more information about Medicare Appeals and Grievances.

The DMP may not apply to you if you have certain medical conditions, such as cancer, you are
receiving hospice, palliative, or end-of-life care, or live in a long-term care facility.

What can I do if I need help to stop taking opioids?

Call us. GlobalHealth plans have benefits for opioid use disorder.