State Tobacco Cessation Coverage

Medicaid Coverage

The Montana Medicaid program covers:

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

Bupropion (Zyban)
Group Counseling
Individual Counseling

Members are limited to four months of treatment per quit attempt, and are covered for 4 quit attempts per lifetime. Members must try first-line medications (NRT patch, varenicline, bupropion) before they are allowed to try second-line medications (NRT gum, inhaler, nasal spray, lozenge). Prior authorization is required on these second-line medications.

For more information, please call Montana Medicaid at 800-362-8312, or visit their website at http://www.dphhs.mt.gov/programsservices/medicaid.shtml

View Medicaid Coverage Details

State Employee Health Plan Coverage

The State Employee Benefits Plan does not provide any coverage:

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

Bupropion (Zyban)
Group Counseling
Individual Counseling
Phone Counseling

Cessation medications are specifically excluded from coverage.

For more information, please call the Montana Health Care and Benefits Division at 406-444-7462 or 800-287-8266, or visit their website at http://benefits.mt.gov/

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 Montana Tobacco QuitLine is open 7AM-9PM (M-TH), 7AM-7PM(F), 8AM-4:30PM (SAT-SUN) (Mountain Time). You can reach the Montana Tobacco QuitLine by calling 1-800-QUIT-NOW.

American Lung Association Resources

The American Lung Association of Montana provides smoking cessation services statewide. 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 406-442-6556, or visit us at http://www.lungusa2.org/northernrockies/index.html

Medicaid Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program
NRT Patch	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program
NRT Nasal Spray	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program
NRT Lozenge	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program
NRT Inhaler	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program
Varenicline (Chantix)	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program
Bupropion (Zyban)	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program
Group Counseling	No	Montana Department of Public Health and Human Services, Claim Jumper Newsletter, Volume XXI, Issue 11, November 2007
Individual Counseling	Yes	Montana Department of Public Health and Human Services, Claim Jumper Newsletter, Volume XXI, Issue 11, November 2007

Type of Barrier	State Has Barrier?	Data Source
Limits on duration	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program
Lifetime limit on quit attempts	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program
Annual limit on quit attempts	No
Prior authorization required	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program
Co-payments required	Yes	Montana Department of Public Health and Human Services, "Your Health Care Coverage: Montana Medicaid", January 2008
Stepped-care therapy	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program
Counseling Required for Medications	No
Dollar Limit	No
Other	Yes	Montana Department of Public Health and Human Services, Provider Manual, Prescription Drug Program

Additional Data Sources
Montana Medicaid, Member Handbook, January 1, 2008

State Employee Health Plan Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	No	State of Montana, Employee Benefits Summary Plan Document
NRT Patch	No	State of Montana, Employee Benefits Summary Plan Document
NRT Nasal Spray	No	State of Montana, Employee Benefits Summary Plan Document
NRT Lozenge	No	State of Montana, Employee Benefits Summary Plan Document
NRT Inhaler	No	State of Montana, Employee Benefits Summary Plan Document
Varenicline (Chantix)	No	State of Montana, Employee Benefits Summary Plan Document
Bupropion (Zyban)	No	State of Montana, Employee Benefits Summary Plan Document
Group Counseling	No	State of Montana, Employee Benefits Summary Plan Document
Individual Counseling	No	State of Montana, Employee Benefits Summary Plan Document
Phone Counseling	Yes	State of Montana, Employee Benefits Annual Change Booklet
Online Counseling	No	State of Montana, Employee Benefits Summary Plan Document
Quit Kit	No	State of Montana, Employee Benefits Summary Plan Document

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
State of Montana, Health Care and Benefits Division, "Employee Benefit Options"

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	No
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

Stop Smoking

Lung HelpLine

E-Newsletter

Montana