Public health insurance quit-smoking coverage
Public health insurance plans provide health insurance at a lower cost for eligible individuals, children, families, seniors, and people with disabilities. In Massachusetts, public health plans include MassHealth (Medicaid), and Medicare.
Massachusetts public health plans offer coverage for quit-smoking medicines and counseling. Look at the listings below to get more details about which benefits are covered.
Private health plans, HMOs, or other plans provided through employers also offer quit-smoking benefits, but coverage varies, so be sure to check with your plan.
MassHealth
MassHealth pays for health care for certain low- and medium-income people living in Massachusetts, including a program for individuals who are HIV positive. To see if you might qualify for MassHealth, call 1-888-665-9993 or visit www.mass.gov/masshealth.
If you have Masshealth you can make two quit attempts per year with prescription medications, or unlimited quit attempts per year using over-the-counter medications. Click here to download a factsheet on MassHealth coverage.
Stop-smoking Medicines
MassHealth covers stop-smoking medicines for your usual co-pay.
- nicotine patch
- nicotine gum
- nicotine lozenge
- pill (Wellbutrin/Zyban/Burpropion/Chantix)
- nicotine inhaler
- nicotine nasal spray
Counseling
- MassHealth covers counseling for free.
Medicare
Medicare is a health insurance program for people age 65 or older and people under age 65 with certain disabilities. For more information call Medicare customer service at 1-800-MEDICARE (English and Spanish) or visit www.medicare.gov.
Stop-smoking Medicines
Medicare Part D covers these FDA-approved prescription medications. No prior authorization is required.
- bupropion
- Chantix
- nicotine inhaler
- nicotine nasal spray
Supplemental Insurance Coverage:
- If you are covered by MassHealth in addition to Medicare, MassHealth will cover the nicotine patch, nicotine gum, and nicotine lozenge. No prior authorization is required. Your usual co-pay applies.
- For other supplemental insurance coverage, check with your insurer.
Counseling
Medicare Part B and Part D cover counseling for two quit attempts per year, a maximum of four sessions per quit attempt.
- Counseling must be provided by a qualified doctor or other Medicare-recognized practitioner.
If you have not been diagnosed with a condition caused by smoking, Medicare will pay the full allowable amount and you will have no out-of-pocket cost.
If you have been diagnosed with or exhibit symptoms of a tobacco-related disease, you are responsible for co-pay, co-insurance and unmet deductible.
