Medicaid Coverage

SoonerCare covers:

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

All seven medications are covered. Group counseling is not covered, but individual counseling is. Medications have no limits, except for Chantix which is 180 days per 12 months. Counseling is limited to 8 sessions per year.

For more information, please call the Oklahoma Health Care Authority at 405-522-7300, or visit their website at www.okhca.org

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 Oklahoma Employee Benefits Council covers:

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

The NRT nasal spray, NRT inahler, bupropion, varenicline and phone counseling. The NRT gum, NRT patch, NRT lozenge and indivual counseling vary by plan. All plans limit the duration of treatment and some plans charge co-pays.

For more information, please call the Oklahoma Employee Benefits Council at 405-232-1190 or 800-219-8115, or visit their website at http://www.ebc.state.ok.us/en/

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-QUIT-NOW; http://www.ok.gov/helpline

Hours: 24 hours, Monday-Sunday

Eligibility to recieve counseling: Age; readiness. For medication: insured participants are eligible for the single call program and get 2 weeks of patches, gum or lozenge; uninsured participants are eligible for enrollment in the intensive, proactive program and can receive up to 8 weeks of combination therapy, free patches, gum or lozenge.

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 Oklahoma. 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 918-747-3441, or visit us at http://www.oklung.org.