Medicaid Coverage

The New York Medicaid program covers:

  • yesNicotine Gum
  • yesNicotine Patch
  • yesNicotine Nasal Spray
  • yesNicotine Lozenge
  • variesNicotine Inhaler
  • yesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • yesGroup Counseling
  • yesIndividual Counseling
  • variesQuitline

The NRT gum, lozenge, patch, nasal spray, varenicline, and bupropion are covered by all plans. Coverage of the NRT inhaler varies by plan. Group and individual counseling are covered by all plans. Some plans charge copays, but not for pregnant women.

For more information, please call 1-800-633-4227 or visit the website of the New York State Department of Health at http://www.health.state.ny.us/health_care/medicaid/

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 New York state employee health plans cover:

  • variesNicotine Gum
  • variesNicotine Patch
  • variesNicotine Nasal Spray
  • variesNicotine Lozenge
  • variesNicotine Inhaler
  • yesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • noGroup Counseling
  • variesIndividual Counseling
  • variesPhone Counseling
  • yesNo Tobacco Surcharge

The NRT inhaler, NRT nasal spray, bupropion and varenicline. Coverage of counseling varies by plan. All plans require co-payments and counseling prior to receiving medications.

For more information, please call the New York State Health Insurance Plan at 518-457-2487 or 877-697-5627, or visit their website at http://www.cs.state.ny.us/ebd/welcome/login.cfm

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: 1-866-NY-QUITS; http://www.nysmokefree.com/

Hours: 9:00 AM - 9:00 PM Monday-Thursday; 9:00 AM - 5:00 PM Saturday and Sunday

Eligibility to recieve counseling: NYS resident. For medication: age 18+; NYS resident; 10cig/day or more; plan to quit within 30 days or recently quit smoker currently using NRT for up to 30 days or recently quit smoker up to 2 weeks and not using NRT; no contraindications; agree to quit date callback.

Medications provided:

  • noNicotine 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 New York 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 631-265-3848 or visit us online at http://www.alany.org.