State Tobacco Cessation Coverage

Medicaid Coverage

MOHealthnet does not provide any cessation coverage:

NRT Gum
NRT Patch
NRT Nasal Spray
NRT Inhaler
NRT Lozenge
Varenicline (Chantix)

Bupropion (Zyban)
Group Counseling
Individual Counseling

Cessation treatments are specifically excluded from coverage. Counseling may be provided for pregnant women, depending on health plan.

For more information, please call the MOHealthnet Division at 888-275-5908, or visit their website at http://www.dss.mo.gov/fsd/msmed.htm

View Medicaid Coverage Details

State Employee Health Plan Coverage

The Missouri Consolidated Health Care Plan covers:

NRT Gum
NRT Patch
NRT Nasal Spray
NRT Inhaler
NRT Lozenge
Varenicline (Chantix)

Bupropion (Zyban)
Group Counseling
Individual Counseling
Phone Counseling

Coverage of nasal spray, varenicline and bupropion is only available to members of the Mercy Health Plan. Coventry Health Plan does not provide cessation coverage. Co-payments are required for medications. Prior authorization is required also.

For more information, please call the Missouri Consolidated Health Care Plan at 800-487-0771, or visit their website at http://www.mchcp.org/

View State Employee Health Plan Coverage Details

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

The Missouri Tobacco QuitLine is open 7AM-9PM (Central Time). You can reach the Missouri Tobacco QuitLine by calling 1-800-QUIT-NOW.

American Lung Association Resources

The American Lung Association's Freedom From Smoking® program is widely available throughout the state of Missouri. Not On Tobacco is offered in select high schools. Additional resources 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 more information about program locations and schedules, call 314-645-5505 or visit us at http://www.breathehealthy.org

Medicaid Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	No	Missouri Department of Social Services, Pharmacy Program, "List of Drugs Excluded from Coverage Under MO HealthNet Program"
NRT Patch	No	Missouri Department of Social Services, Pharmacy Program, "List of Drugs Excluded from Coverage Under MO HealthNet Program"
NRT Nasal Spray	No	Missouri Department of Social Services, Pharmacy Program, "List of Drugs Excluded from Coverage Under MO HealthNet Program"
NRT Lozenge	No	Missouri Department of Social Services, Pharmacy Program, "List of Drugs Excluded from Coverage Under MO HealthNet Program"
NRT Inhaler	No	Missouri Department of Social Services, Pharmacy Program, "List of Drugs Excluded from Coverage Under MO HealthNet Program"
Varenicline (Chantix)	No	Missouri Department of Social Services, Pharmacy Program, "List of Drugs Excluded from Coverage Under MO HealthNet Program"
Bupropion (Zyban)	No	Missouri Department of Social Services, Pharmacy Program, "List of Drugs Excluded from Coverage Under MO HealthNet Program"
Group Counseling	No	Missouri Patient Care Review Foundation, "External Review of MC+ Medicaid Managed Care in Missouri", February 2002
Individual Counseling	No	Missouri Patient Care Review Foundation, "External Review of MC+ Medicaid Managed Care in Missouri", February 2002

Type of Barrier	State Has Barrier?	Data Source
Limits on duration	n/a
Lifetime limit on quit attempts	n/a
Annual limit on quit attempts	n/a
Prior authorization required	n/a
Co-payments required	n/a
Stepped-care therapy	n/a
Counseling Required for Medications	n/a
Dollar Limit	n/a
Other

State Employee Health Plan Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	No
NRT Patch	No
NRT Nasal Spray	Varies	Mercy Health Plans, Drug Formulary, 2009
NRT Lozenge	No
NRT Inhaler	No
Varenicline (Chantix)	Varies	Mercy Health Plans, Drug Formulary, 2009
Bupropion (Zyban)	Varies	Mercy Health Plans, Drug Formulary, 2009
Group Counseling	No
Individual Counseling	No
Phone Counseling	No
Online Counseling	Varies	Mercy Health Plans, "Tobacco Cessation"
Quit Kit	No

Type of Barrier	State Has Barrier?	Data Source
Limits on duration	No
Lifetime limit on quit attempts	No
Annual limit on quit attempts	No
Prior authorization required	Yes	Mercy Health Plans, Drug Formulary, 2009
Co-payments required	Yes	Mercy Health Plans, Drug Formulary, 2009
Stepped-care therapy	No
Counseling Required for Medications	No
Dollar Limit	Yes	2009 MCHCP Handbook

Additional Data Sources
Coventry Health Care, Member Drug Formulary, Alphabetical Listing 2008
Missouri Consolidated Health Care Plan, Medical Benefits

Private Insurance Coverage Details

Type	Value	Data Source
Cessation mandate on the books	No
Mandate applies to all insurance carriers	n/a
Mandate applies to all populations	n/a
State mandates wellness program including smoking cessation	No
Other stipulations	n/a

Type	Value	Data Source
NRT Gum	n/a
NRT Patch	n/a
NRT Nasal Spray	n/a
NRT Lozenge	n/a
NRT Inhaler	n/a
Varenicline (Chantix)	n/a
Bupropion (Zyban)	n/a
Group Counseling	n/a
Individual Counseling	n/a

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