Medicaid Coverage

MaineCare covers:

  • yesNRT Gum
  • yesNRT Patch
  • yesNRT Nasal Spray
  • yesNRT Lozenge
  • yesNRT Inhaler
  • yesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • yesGroup Counseling
  • yesIndividual Counseling
  • noQuitline

Prior authorization is required for the NRT nasal spray and inhaler, and members must try other medications first before choosing these treatments.

For more information, please call the Office of MaineCare Services at 207-624-7539 or 800-321-5557, or visit their website at http://www.state.me.us/bms/.

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. Also note: the coverage information above applies to traditional Medicaid. Coverage information for the Medicaid expansion population is still to be determined.

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

For state employees, Maine covers:

  • yesNRT Gum
  • yesNRT Patch
  • yesNRT Nasal Spray
  • yesNRT Lozenge
  • yesNRT Inhaler
  • yesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • yesGroup Counseling
  • yesIndividual Counseling
  • noPhone Counseling
  • yesNo Tobacco Surcharge

Anthem Blue Cross Blue Shield will pay for cessation medications up to $200 per year and $400 per lifetime. The plan covers individual follow-up visits with a member's physician for cessation counseling. It also covers enrollment in 2 group counseling classes per lifetime (provided through hospitals or physician's offices). Co-payments of $10-$30 are also required.

For more information, please call the Division of Employee Health Benefits at 207-287-6780 or 800-422-4503, or visit their website at http://www.state.me.us/beh/

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: 1-800-207-1230; http://www.tobaccofreemaine.org/

Hours: 8 AM - 8 PM Monday-Friday; closed Saturday & Sunday

Eligibility to recieve counseling: All callers eligible for 1-call; eligibility for multiple-call includes: Resident of Maine, Age, Readiness to quit within 30 days; for medication: Must be enrolled in multi-call program and ready to quit within 30 days; must have no insurance benefit for NRT, age 18+, with no medical exclusions.

Medications provided:

  • yesNRT Gum
  • yesNRT Patch
  • noNRT Nasal Spray
  • yesNRT Lozenge
  • noNRT Inhaler
  • noVarenicline (Chantix)
  • noBupropion (Zyban)

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

American Lung Association Resources

The American Lung Association of Maine 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 207-622-6394 or visit us online at http://www.lung.