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Medicaid, Primary Care Network (PCN), and Medicare Tobacco Cessation Benefits

Medicaid and Primary Care Network (PCN) Benefits

Cessation Counseling and Support
All Medicaid and PCN enrollees are eligible for intensive cessation counseling through the Utah Tobacco Quit Line (1-800.QUIT.NOW). Intensive counseling includes up to five sessions lasting 40 minutes each. Up to eight weeks of nicotine replacement therapy (patch or gum) is available to those enrolled in this intensive counseling program.

Cessation Medications- To view the medication benefits for Medicaid and PCN clients go to:
http://www.tobaccofreeutah.org/medpcnbenefits.pdf

 

Medicare Benefits

Cessation Counseling and Support
Smoking cessation (non medication) falls under Medicare Part B (medical). Cessation is covered if a doctor orders it. It covers counseling for counseling for two attempts during a 12-month period IF the person is diagnosed with a smoking-related illness or is taking medication that may be affected by tobacco use. Counseling for each attempt includes up to four face-to-face visits.

Co-insurance (usually 20%) and Part B deductible may apply.

Cessation Medications
Any medication that Medicare covers would be under Medicare Part D. There are ~54 Part D plans, and a person must have one of the plans that covers cessation medication


This webpage is for informational purposes only. The accuracy, reliability, or completeness of any of the information cannot be guaranteed. If you wish to obtain information about your benefits, contact your health plan directly.

 

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