Medicaid Coverage

The West Virginia Medicaid program covers:

  • yesNRT Gum
  • yesNRT Patch
  • yesNRT Nasal Spray
  • yesNRT Lozenge
  • yesNRT Inhaler
  • noVarenicline (Chantix)
  • yesBupropion (Zyban)
  • variesGroup Counseling
  • noIndividual Counseling
  • variesQuitline

Coverage varies by plan. Prior authorization is required for all medications. Co-payments of $0.50-$3 are required. Quit attempts are limited to one per year, though pregnant women may attempt more. Coverage is limited to 12 weeks per attempt and other medications must be used before the nicotine replacement therapy inhaler.

For more information, please call the West Virginia Bureau for Medical Services at 304-558-6006, or visit their website at http://www.wvdhhr.org/bms/

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 Insurance Agency covers:

  • yesNRT Gum
  • yesNRT Patch
  • yesNRT Nasal Spray
  • yesNRT Lozenge
  • yesNRT Inhaler
  • yesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • noGroup Counseling
  • yesIndividual Counseling
  • noPhone Counseling
  • noOnline Counseling
  • noNo Tobacco Surcharge

Members are covered for 3 quit attempts per lifetime. Members may receive individual counseling from a physician up to two times per year. Co-payments are not required for NRT patch. $5 copayments are required for the NRT gum and bupropion. $15 copayments are required for the NRT lozenge. $50 copayments are required for varenicline, NRT nasal spray, and NRT inhaler. State employees who use tobacco are charged $25/month in extra health insurance premiums for individual coverage and $50/month for family coverage.

For more information, please call the West Virginia Public Employees Insurance Agency at 304-353-7820 or 888-440-7342, or visit their website at http://www.westvirginia.com/peia/

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: 1-877-966-8784; http://www.wvquitline.com/

Hours: 8 AM - 8 PM Monday-Friday; 8:00 AM - 5 PM Saturday & Sunday

Eligibility to recieve counseling: West Virginia resident; for medication: West Virginia resident.

Medications provided:

  • yesNRT Gum
  • yesNRT Patch
  • noNRT Nasal Spray
  • yesNRT Lozenge
  • noNRT 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 West Virginia. Not On Tobacco is offered in select high schools. 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 1-800-LUNGUSA, or visit http://www.lunginfo.org.