Medicaid Coverage

The Washington Medicaid program covers:

  • variesNRT Gum
  • variesNRT Patch
  • variesNRT Nasal Spray
  • variesNRT Lozenge
  • variesNRT Inhaler
  • variesVarenicline (Chantix)
  • variesBupropion (Zyban)
  • noGroup Counseling
  • variesIndividual Counseling
  • variesQuitline
  • yesSubmitted Section 2502 SPA?

Fee-for-service Medicaid covers gum, patch, lozenge and bupropion in conjunction with phone counseling through the state quitline (1-800-QUIT-NOW). All Healthy Options managed care plans are required to provide some level of smoking cessation services, but they vary plan-to-plan.

For more information, please call the Washington Medicaid Office at 800-562-3022, or visit their website at http://www.hca.wa.gov/medicaid/Pages/index.aspx

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. Also note: the coverage information above applies to traditional Medicaid. Coverage information for the Medicaid expansion population is still to be determined.

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 Public Employees Benefits Board covers:

  • yesNRT Gum
  • yesNRT Patch
  • variesNRT Nasal Spray
  • variesNRT Lozenge
  • variesNRT Inhaler
  • variesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • variesGroup Counseling
  • variesIndividual Counseling
  • variesPhone Counseling
  • yesOnline Counseling
  • noNo Tobacco Surcharge

Members should contact their insurance plan for information on specific coverage. All plans require members to receive counseling to receive medications. Aetna, Group Health, and UMP members have access to the Free and Clear program. For links to specific plans, please see the sources section of this page.

For more information, please call the Washington Public Employees Benefits Board at 360-412-4200 or 800-200-1004, or visit their website at http://www.pebb.hca.wa.gov/

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.quitline.com/

Hours: 24 hours Monday-Sunday

Eligibility to recieve counseling: 18 and over. Ready to quit within 30 days or already quit. Resident of Washington State. Note: As of August 1, 2013 WA Medicaid callers and private insurance enrollees have access to five-call service

Medications provided:

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

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

American Lung Association Resources

The American Lung Association 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 1-800-LUNG-USA or visit us online at http://www.lungusa.org