Medicaid Coverage

The Kentucky Medicaid program covers:

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

All seven pharmacotherapy treatments are covered. Individual and group counseling are covered. No barriers. Kentucky passed a law in 2017 requiring insurance coverage for FDA-approved and USPSTF-recommended tobacco cessation medicines and services for commercial health plans and Medicaid plans in Kentucky. Kentucky now has a comprehensive cessation benefit.

For more information, please call the Department for Medicaid Services at 800-372-2973, or visit their website at https://chfs.ky.gov/agencies/dms/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 Kentucky Employees Health Plan covers:

  • yesNicotine Gum
  • yesNicotine Patch
  • yesNicotine Nasal Spray
  • yesNicotine Lozenge
  • yesNicotine Inhaler
  • yesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • yesGroup Counseling
  • noIndividual Counseling
  • yesPhone Counseling
  • noNo Tobacco Surcharge

All 7 pharmacotherapy treatments covered. Group counseling and phone counseling are also covered. There is a duration limit of 28 days for OTC NRT. Regular counseling sessions from an approved tobacco cessation program are also required for OTC NRT.

For more information, please call the Kentucky Personnel DEI Member Services Branch at 888-581-8834 or 502-564-6534, or visit their website at https://personnel.ky.gov/Pages/healthinsurance.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; http://www.quitnowkentucky.org

Hours: 8:00 AM - 1:00 AM Monday-Saturday; 8:00 AM - 8:00 AM Sunday

Eligibility to recieve counseling: A resident of Kentucky age 15 and older. For medication: a resident of Kentucky, age 18, uninsured, enrolled in counseling.

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 available in several locations throughout the state of Kentucky. Additional resources 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 800-LUNGUSA, or visit our website at http://www.midlandlung.org.