Medicaid Coverage

The West Virginia Medicaid program covers:

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

All seven pharmacotherapy treatments are covered. Group and phone counseling coverage varies by plan. Prior authorization is required for all medication. Step therapy is required for the inhaler, nasal spray and Chantix.

For more information, please call the West Virginia Bureau for Medical Services at 304-558-1700, or visit their website at http://dhhr.wv.gov/bms/Pages/default.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.

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:

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

All seven pharmacotherapy treatments are covered. Individual counseling is covered. There is a duration limit of 12 weeks for all medications and two counseling sessions per year.

For more information, please call the West Virginia Public Employees Insurance Agency at 304-558-7850 or 888-680-7342, or visit their website at http://peia.wv.gov/Pages/default.aspx

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

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

Eligibility to recieve counseling: West Virginia resident. For medication: West Virginia resident.

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 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.