State Tobacco Cessation Coverage

Medicaid Coverage

The Oregon Health Plan covers:

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

Bupropion (Zyban)
Group Counseling
Individual Counseling

Treatment is available every 3 months. Counseling is limited to 10 sessions per course of treatment. Co-payments of $2-3 are required.

For more information, please call the Oregon Health Plan Office at 503-945-5772, or visit their website at http://www.oregon.gov/DHS/healthplan/index.shtml

View Medicaid Coverage Details

State Employee Health Plan Coverage

The Public Employees Benefit Board covers:

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

Bupropion (Zyban)
Group Counseling
Individual Counseling
Phone Counseling

Co-payments of $1-5 are required for varenicline and bupropion, depending on health plan. Patients receive medications through the Quit for Life phone counseling program. Please visit www.quitnow.net/PEBB/Default.aspx to enroll.

For more information, please call the Oregon Public Employees' Benefit Board at 503-373-1102 or 800-788-0520, or visit their website at http://oregon.gov/DAS/PEBB/

View State Employee Health Plan Coverage Details

Private Insurance Coverage

Beginning January 1, 2010, insurance plans are required to cover a physician-recommended tobacco cessation program for all members 15-years old or older. Plans are required to provide at least $500 of coverage for such programs, and they are to include educational and medical treatment components.

View State Mandates on Private Insurance Details

Quitline

The Oregon Quitline is open 5AM-midnight (Pacific Time). You can reach the Oregon Quitline by calling 1-800-QUIT-NOW. The quitline is also available in Spanish: 1-877-2NO-FUME (1-877-266-3863).

American Lung Association Resources

The American Lung Association in Oregon offers Freedom From Smoking classes in some areas of the state. Some Oregon high schools also offer N-O-T On Tobacco, the teen tobacco cessation program. For more information, please contact Cheryl Owen at cheri@lungoregon.org or 866-661-5864.

Medicaid Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	Yes	Oregon Administrative Rules, Department of Human Services, Division of Medical Assistance Programs, Division 130: Medical-Surgical Services, 410-130-0000
NRT Patch	Yes	Oregon Administrative Rules, Department of Human Services, Division of Medical Assistance Programs, Division 130: Medical-Surgical Services, 410-130-0000
NRT Nasal Spray	Yes	Oregon Administrative Rules, Department of Human Services, Division of Medical Assistance Programs, Division 130: Medical-Surgical Services, 410-130-0000
NRT Lozenge	Yes	Oregon Administrative Rules, Department of Human Services, Division of Medical Assistance Programs, Division 130: Medical-Surgical Services, 410-130-0000
NRT Inhaler	Yes	Oregon Administrative Rules, Department of Human Services, Division of Medical Assistance Programs, Division 130: Medical-Surgical Services, 410-130-0000
Varenicline (Chantix)	Yes	Oregon Administrative Rules, Department of Human Services, Division of Medical Assistance Programs, Division 130: Medical-Surgical Services, 410-130-0000
Bupropion (Zyban)	Yes	Oregon Administrative Rules, Department of Human Services, Division of Medical Assistance Programs, Division 130: Medical-Surgical Services, 410-130-0000
Group Counseling	Yes	Oregon Administrative Rules, Department of Human Services, Division of Medical Assistance Programs, Division 130: Medical-Surgical Services, 410-130-0000
Individual Counseling	Yes	Oregon Administrative Rules, Department of Human Services, Division of Medical Assistance Programs, Division 130: Medical-Surgical Services, 410-130-0000

Type of Barrier	State Has Barrier?	Data Source
Limits on duration	No	Oregon Administrative Rules, Department of Human Services, Division of Medical Assistance Programs, Division 130: Medical-Surgical Services, 410-130-0000
Lifetime limit on quit attempts	No
Annual limit on quit attempts	No
Prior authorization required	No
Co-payments required	Yes	Department of Human Services, Oregon Health Plan, July 2007, Client Handbook
Stepped-care therapy	No
Counseling Required for Medications	No
Dollar Limit	No
Other	Yes	Oregon Administrative Rules, Department of Human Services, Division of Medical Assistance Programs, Division 130: Medical-Surgical Services, 410-130-0000

Additional Data Sources
State of Oregon, Health Services Commission, Prioritized List of Health Services
Oregon Health Plan, Provider Services Contract Template

State Employee Health Plan Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	Yes	State of Oregon, Public Employees Benefits Board, "You can quit"
NRT Patch	Yes	State of Oregon, Public Employees Benefits Board, "You can quit"
NRT Nasal Spray	No	State of Oregon, Public Employees Benefits Board, "You can quit"
NRT Lozenge	No	State of Oregon, Public Employees Benefits Board, "You can quit"
NRT Inhaler	No	State of Oregon, Public Employees Benefits Board, "You can quit"
Varenicline (Chantix)	Yes	State of Oregon, Public Employees Benefits Board, "You can quit"
Bupropion (Zyban)	Yes	State of Oregon, Public Employees Benefits Board, "You can quit"
Group Counseling	No	State of Oregon, Public Employees Benefits Board, "You can quit"
Individual Counseling	No	State of Oregon, Public Employees Benefits Board, "You can quit"
Phone Counseling	Yes	State of Oregon, Public Employees Benefits Board, "You can quit"
Online Counseling	Yes	State of Oregon, Public Employees Benefits Board, "You can quit"
Quit Kit	Yes	State of Oregon, Public Employees Benefits Board, "You can quit"

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	No
Co-payments required	Varies	State of Oregon, Public Employees Benefits Board, "You can quit"
Stepped-care therapy	No
Counseling Required for Medications	Yes	State of Oregon, Public Employees Benefits Board, "You can quit"
Dollar Limit	No

Additional Data Sources
Free and Clear, "Ready to Quit? Welcome PEBB Members!"

Private Insurance Coverage Details

Type	Value	Data Source
Cessation mandate on the books	Yes	Oregon Legislative Assembly, 2009 Regular Session, Enrolled Senate Bill 734
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

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