Massachusetts Tobacco Cessation and Prevention Program, MDPH Updated 3/15/2012 Over-the-counter stop-smoking medicines covered: GIC Members
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1 Over-the-counter stop-smoking medicines covered: GIC Members MassHealth (Medicaid) Federal Employee Health Benefits Fallon Community Benefit information line N/A or Harvard Pilgrim: Primary Choice & Independence plans Tufts: Navigator, MedPref, Spirit plans Caremark: Nicotine patch Nicotine gum Nicotine lozenge Is a prescription required? Co-pay (for 90 day supply) Comments 90 day supply; allowed twice per year $6 ($1 per box; each box is usually a 14- day supply) No annual limit or lifetime limit Per manufacturer recommendations s for up to 3 months supply for patch, gum, or lozenge. Only generic versions are covered. 90 days Prescription required to receive meds with the covered co-pay. Prescription required to receive meds, or receive the drugs as part of a planapproved tobacco cessation program. over-thecounter over-thecounter No prior authorization required-no quantity limits unless mandated by manufacturer. All medication coverage requires prescription and generic medications are mandatory when available. over-the-counter over-the-counter
2 Prescription stop-smoking medicines covered: GIC members MassHealth FEHB Fallon Harvard Pilgrim Tufts Navgtr & MedPref Zyban Wellbutrin SR (Brand) Bupropion (Generic) Chantix Nicotine inhaler Nicotine nasal spray 90-day supply; can get twice a year No annual limit or lifetime limit 90-day supply; can get twice a year Covered 1 st 90 days with a Tier copay; 2 nd 90 days $50.00 or 50% of cost, whichever is greater Bupropion: 60-day supply permissible on initial fill, 90-day supply permissible thereafter. 24-week supply of Chantix once a year 24-week supply of Chantix once per year; 90-day supply of the other three medicines once per year. Zyban 180 tablets per year. One 12-week supply 90 day supply Co-pay for 90-day supply Zyban $9 in person $75.00 Wellbutrin SR $9 in person $ Bupropion $3 in person Chantix $9 in person Nicotine inhaler Nicotine nasal spray $ week supply $50.00 $20 $110 $10 for 30 days in person; $20 for 3 month supply by mail $25 for 30 days in person; $50 for 3 month supply by mail $50 for 30 days and $110 for 90 days. $50 for 30 days and $110 for 90 days. $30 in person $171 for a 12-week supply
3 Comments 1 st 90 day supply Wellbutrin SR Prescriptions must be at no cost once a Step, paid for in advance. year. 2 nd 90 day prior authorization Proof of enrollment in a supply $50.00 or required smoking cessation 50% of the cost, program required for whichever is reimbursement. Only 1 greater. Patch is application submission $30 in person, or is allowed for $20 by mail reimbursement. Per Chantix not year? available through mail-order. Counseling support to stop smoking covered: GIC members Counseling support to stop smoking is covered What is covered? Co-pay MassHealth FEHB Fallon Face-to-face individual and group sessions Up to 16 face-toface sessions per year Harvard Pilgrim Tufts Navgtr & MedPref Face-to-face individual and group sessions * * * * At least 4 sessions of 30 minutes each; at least twice a year for the class; if patient wishes to purchase NRT from instructor there is a fee.
4 Comments *No external *Up to $50.00 *No external stop-smoking support. Counseling sessions with any MassHealth provider with the exception of mental health and substance abuse counselors. providers covered. Phone and in-person support with Fallon health coaches through the Quit-To- Win program is available. Weekly Quit-to-Win classes available in Auburn, Leominster, Clinton, Gardner, and Worcester. Call reimbursement for smoking cessation program for members with the following conditions: Asthma, Diabetes, Coronary Heart Disease, pregnancy, High Cholesterol and must have at least 50% attendance record. *No external providers covered. Unlimited phone is available with a certified tobacco specialist at. Phone is provided in English or Spanish and interpreter services are available for other languages. providers covered. Phone and support with Harvard Pilgrim health coaches only. No coverage of stopsmoking support.
5 Health Care Spending Account: GIC members Employees enrolled in the GIC's Health Care Spending Account (HCSA) can spend their HCSA money on tobacco cessation products, including: over-the-counter stop-smoking medicines prescription stop-smoking medicines support to stop smoking
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