Medicaid Coverage

The North Dakota Medicaid program covers:

  • yesNicotine Gum
  • yesNicotine Patch
  • yesNicotine Nasal Spray
  • yesNicotine Lozenge
  • yesNicotine Inhaler
  • yesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • noGroup Counseling
  • variesIndividual Counseling
  • yesQuitline

All seven pharmacotherapy treatments and medications are covered. Group counseling is available only through rehab providers. Individual counseling is covered for pregnant women. Medications are limited to a 90-day supply, except for varenicline, which can be extended 24 weeks if patient has successfully quit. 4 sessions of counseling are available to pregnant women per quit attempt. Prior authorization is required for all medications. 1 attempt with the patch, gum, lozenge, Chantix, and bupropion every 2 years are covered. 2 attempts per year for counseling are covered for pregnant women. There are $3 copayments for brand-name medications and no co-payments for generics. Stepped Care Therapy is required to get the inhaler â€' patients must try another NRT beforehand. Patients must enroll in the quitline and complete a first call to received medications (don't need to enroll in additional calls).

For more information, please call the North Dakota Department of Human Services at 701-328-2310 or 800-472-2622, or visit their website at http://www.nd.gov/dhs/services/medicalserv/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 North Dakota Public Employees Retirement System covers:

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

All seven medications and all three forms of counsling. Counseling is limited to 8 weeks. Blue Cross, Blue Shield of North Dakota will pay up to $200 every two years for group counseling, and $500 every two years for medications and/or individual counseling.

For more information, please call the North Dakota Public Employees Retirement System at 701-328-3900 or 800-803-7377, or visit their website at http://www.nd.gov/ndpers/insurance-plans/group-health.html

Private Insurance Coverage

Standard insurance plans in North Dakota must include a $150 lifetime smoking cessation benefit. This requirement only applies to small employers, and employers have other plans to choose from when purchasing insurance. This benefit is therefore not guaranteed to be included.

Quitline

Contact Information: 1-800-QUIT-NOW; 1-866-388-7848; http://www.ndhealth.gov/ndquits

Hours: 7:00 AM - 9:00 PM Monday-Thursday; 7:00 AM - 7:00 PM Friday; closed Saturday and Sunday

Eligibility to recieve counseling: Must be a ND resident or spend at least half their time in ND. For medication: 8 week supply available to any North Dakota resident (18 and older) who enrolls in counseling and is uninsured or underinsured.

Medications provided:

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

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

American Lung Association Resources

The American Lung Association's Freedom from Smoking® program is widely available in community locations throughout the state of North Dakota. Additional 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 more information about program locations and schedules, call 701 223-5613, or visit us at http://www.lungnd.org