State Tobacco Cessation Coverage

Medicaid Coverage

The Florida Medicaid program covers:

NRT Gum
NRT Patch
NRT Nasal Spray
NRT Inhaler
NRT Lozenge
Varenicline (Chantix)

Bupropion (Zyban)
Group Counseling
Individual Counseling

Medications coverage varies by managed care organization. All managed care plans are required to cover a smoking cessation program. Check with your health plan for more details. NRT patch and bupropion are covered for fee for service members, as well as individual counseling with a doctor.

For more information, please call the Florida Medicaid office at 888-419-3456 or visit their website at http://www.fdhc.state.fl.us/Medicaid/index.shtml

View Medicaid Coverage Details

State Employee Health Plan Coverage

myHealth does not cover any cessation treatments:

NRT Gum
NRT Patch
NRT Nasal Spray
NRT Inhaler
NRT Lozenge
Varenicline (Chantix)

Bupropion (Zyban)
Group Counseling
Individual Counseling
Phone Counseling

For more information, please call the Florida Department of Management Services at 850-488-2786 or visit their website at http://dms.myflorida.com/

View State Employee Health Plan Coverage Details

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

The Florida Quit-for-Life Quitline is open 7AM-12AM (M-TH), 7AM-9PM(F), 9AM-7PM(SAT-SUN) (Eastern Time). You can reach the Florida Quit-for-Life Quitline by calling 877-822-6669

American Lung Association Resources

The American Lung Association of Florida provides smoking cessation services statewide. 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 further information, please call 800-LUNG-USA or visit us online at http://www.lungfla.org

Medicaid Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?	Yes	Health Plan contract, see pg. 81
NRT Gum	Varies	Multiple Sources. See Additional Sources below.
NRT Patch	Varies	Multiple Sources. See Additional Sources below.
NRT Nasal Spray	Varies	Multiple Sources. See Additional Sources below.
NRT Lozenge	Varies	Multiple Sources. See Additional Sources below.
NRT Inhaler	Varies	Multiple Sources. See Additional Sources below.
Varenicline (Chantix)	Varies	Multiple Sources. See Additional Sources below.
Bupropion (Zyban)	Varies	Multiple Sources. See Additional Sources below.
Group Counseling	Varies	Multiple sources. See Additional Sources below.
Individual Counseling	Yes	Multiple Sources. See Additional Sources below.

Type of Barrier	State Has Barrier?	Data Source
Limits on duration	Varies
Lifetime limit on quit attempts	Varies
Annual limit on quit attempts	Varies
Prior authorization required	Varies
Co-payments required	Varies
Stepped-care therapy	Varies
Counseling Required for Medications	Varies
Dollar Limit	Varies
Other	Varies	Correspondence with Florida Agency for Health Care Administration

Additional Data Sources
Correspondence with Florida Agency for Health Care Administration
Agency for Health Care Administration, Final Draft, September 1 2009, Health Plan Contract Attachment II - Core Contract Provisions
Total Health Choice, Medicaid Formulary 2009
Jackson Memorial Health Plan, Preferred Drug List
CitrusCaid, Preferred Drug List
Amerigroup, Preferred Drug List
Wellcare (Healthease), Preferred Drug List
Freedom Health, Preferred Drug List
Florida Agency for Health Care Administration, Florida Medicaid Preferred Drug List, May 12, 2009
Sunshine State Health Plan, Preferred Drug List
Humana Family Care, Preferred Drug List
Healthy Palm Beaches, Provider Handbook

State Employee Health Plan Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida
NRT Patch	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida
NRT Nasal Spray	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida
NRT Lozenge	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida
NRT Inhaler	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida
Varenicline (Chantix)	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida
Bupropion (Zyban)	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida
Group Counseling	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida
Individual Counseling	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida
Phone Counseling	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida
Online Counseling	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida
Quit Kit	No	Correspondence with Division of State Group Insurance, Department of Management Services, State of Florida

Type of Barrier	State Has Barrier?	Data Source
Limits on duration	n/a
Lifetime limit on quit attempts	n/a
Annual limit on quit attempts	n/a
Prior authorization required	n/a
Co-payments required	n/a
Stepped-care therapy	n/a
Counseling Required for Medications	n/a
Dollar Limit	n/a

Additional Data Sources
Florida Health Care Plans, Smoking Cessation
Group Health Insurance, Plan Booklet and Benefits Document
Vista Healthplans, "Plan Choices and Benefit Summaries", 2008
Capital Health Plan, Health Education Classes
Blue Cross, Blue Shield of Florida, Smoking Cessation
AvMed Health Plans, Benefits Guide

Private Insurance Coverage Details

Type	Value	Data Source
Cessation mandate on the books	No
Mandate applies to all insurance carriers	n/a
Mandate applies to all populations	n/a
State mandates wellness program including smoking cessation	Yes	Fla. Stat. Â§ 627.6402 (2008)
Other stipulations	n/a

Type	Value	Data Source
NRT Gum	n/a
NRT Patch	n/a
NRT Nasal Spray	n/a
NRT Lozenge	n/a
NRT Inhaler	n/a
Varenicline (Chantix)	n/a
Bupropion (Zyban)	n/a
Group Counseling	n/a
Individual Counseling	n/a

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