Medicaid Coverage

The Georgia Medicaid program only covers these treatments:

  • yesNicotine Gum
  • yesNicotine Patch
  • variesNicotine Nasal Spray
  • yesNicotine Lozenge
  • variesNicotine Inhaler
  • variesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • variesGroup Counseling
  • yesIndividual Counseling
  • yesQuitline

Fee for service coverage includes all seven pharmacotherapy treatments and individual counseling. There are quantity limits on all medications, duration limits of 12 weeks for medications and 4 sessions of counseling. Individuals are entitled to 2 quit attempts per year. Prior authorization is required for nasal spray, inhaler, bupropion and varenicline. Co-pays of $0.50 to $3

For more information, please call the Georgia Department of Community Health at 800-869-1150 or visit their website at http://dch.georgia.gov/02/dch/home/0,2467,31446711,00.html

Note: the Affordable Care Act requires all Medicaid programs cover all tobacco cessation medications beginning January 1, 2014. If a medication is marked here as not being covered, there is not yet evidence that Medicaid has complied with this requirement. Patients should call their Medicaid program and ask how to receive these medications.

Health Insurance Marketplace Coverage

All plans in the Health Insurance Marketplace are required to cover tobacco cessation treatment. Specific coverage varies by plan. Check with your insurance plan to find out what is covered.

State Employee Health Plan Coverage

The State Health Benefit Plan covers:

  • yesNicotine Gum
  • yesNicotine Patch
  • yesNicotine Nasal Spray
  • yesNicotine Lozenge
  • yesNicotine Inhaler
  • yesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • variesGroup Counseling
  • variesIndividual Counseling
  • variesPhone Counseling
  • noNo Tobacco Surcharge

Cigna and United health plans cover tobacco cessation meedicaitons for up to 90 days, wtith two quit attempts per year.

For more information, please visit http://dch.georgia.gov/tobacco-surcharges

Private Insurance Coverage

This state does not require private health insurance plans to cover cessation treatments. Cessation coverage in private health insurance plans varies by employer and/or plan. Smokers with this type of health insurance should contact their insurance plan for information on cessation benefits.

This state does not mandate cessation coverage for private insurance plans.

Quitline

Contact Information: 1-877-270-STOP; https://dph.georgia.gov/ready-quit

Hours: 8:00 AM - 12:00 AM Monday-Sunday

Eligibility to recieve counseling: GA Resident; age; readiness to quit. For medication: must be 18 years old, meet basic health requirements, and be ready to quit within the next 30 days.

Medications provided:

  • yesNicotine Gum
  • yesNicotine Patch
  • noNicotine Nasal Spray
  • noNicotine Lozenge
  • noNicotine Inhaler
  • noVarenicline (Chantix)
  • noBupropion (Zyban)

(Source: North American Quitline Consortium, www.naquitline.org)

American Lung Association Resources

The American Lung Association of Georgia provides smoking cessation services statewide. Options include Freedom From Smoking® Online, a program available 24/7 at http://www.ffsonline.org and the American Lung Association's Lung HelpLine (800-LUNG-USA). For further information, please call 770-434-5864 or visit us online at http://www.lung.org.