Medicaid Coverage

The Utah Medicaid program covers:

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

All plans cover all seven pharmacotherapy. Individual counseling is covered for all members and group counseling is limited to pregnant women. Coverage limitations, including duration limits, annual limits, quantity limits, counseling requirements, prior authorization and step therapy, vary by plan. A $4 copay is required for all medication across all plans.

For more information, please call the Utah Medicaid Program at 800-662-9651 or 801-538-6155, or visit their website at https://medicaid.utah.gov/

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 Utah Public Employees Health Program covers:

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

All pharmacotherapy and phone counseling are covered. There is an annual limit of two quit attempts and a duration limit of 180 days per year. Counseling is required for NRT gum, patch and lozenge, which are only offered through the quitline

For more information, please call the Public Employees Health Program at 801-366-7555 or 800-765-7347, or visit their website at http://www.pehp.org/

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; 1-888-567-TRUTH; http://waytoquit.org/

Hours: 24 hours, Monday-Sunday

Eligibility to recieve counseling: State resident ready to quit within 30 days. For medication: up to 8 weeks patch available to those 18 and older who are enrolled in counseling services; NRT also available through select health plans; stand alone web participants can receive 4 weeks of patch or gum or patch + gum.

Medications provided:

  • yesNicotine 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's Freedom From Smoking® program is available in select community locations throughout the state of Utah. Not On Tobacco is widely available throughout the state. 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 (801) 484-4456, or visit us online at http://www.lungutah.org.