Medicaid Coverage

The Rhode Island Medicaid program covers:

  • yesNRT Gum
  • yesNRT Patch
  • yesNRT Nasal Spray
  • yesNRT Lozenge
  • yesNRT Inhaler
  • yesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • variesGroup Counseling
  • yesIndividual Counseling
  • noQuitline
  • noSubmitted Section 2502 SPA?

Fee for Service and Managed Care plans all cover medications. Two 90-day quit attempts are covered per year (Chantix may be extended to 24 weeks). Patient must try Chantix, Bupropion or nicotine replacement patches first unless there is a medical reason not to. At least one counseling session with a clinician is required to receive medication. Coverage of further counseling varies by plan.

For more information, please call the Rhode Island Department of Human Services at 401-784-8100 or 800-964-6211, or visit their website at http://www.dhs.state.ri.us/

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. Also note: the coverage information above applies to traditional Medicaid. Coverage information for the Medicaid expansion population is still to be determined.

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 Tobacco Cessation Program covers:

  • yesNRT Gum
  • yesNRT Patch
  • yesNRT Nasal Spray
  • yesNRT Lozenge
  • yesNRT Inhaler
  • yesVarenicline (Chantix)
  • yesBupropion (Zyban)
  • yesGroup Counseling
  • yesIndividual Counseling
  • yesPhone Counseling
  • noOnline Counseling
  • yesNo Tobacco Surcharge

Co-payments are required for medications and group counseling. Coverage for medication is limited to two months of duration and counseling is covered for a maximum of eight sessions. Members must receive counseling in order to receive medication.

For more information, please call the Rhode Island Office of Employee Benefits at 401-222-3160, or visit their website at http://www.employeebenefits.ri.gov/index.php

Private Insurance Coverage

All private health insurance plans in Rhode Island are required to cover all cessation medications and cessation counseling when prescribed by a physician. Normal co-pays and deductibles may apply. This regulation is being implemented on a rolling basis in new insurance contracts with the state.

Quitline

Contact Information: 1-800-QUIT-NOW; http://www.quitnowri.com/

Hours: 9 AM - 7 PM Monday-Thursday; 9 AM - 5 PM Friday; closed Saturday and Sunday

Eligibility to recieve counseling: Resident of state; for medication: Resident of state, Age 18+, No medical conditions preventing use

Medications provided:

  • noNRT Gum
  • yesNRT Patch
  • noNRT Nasal Spray
  • noNRT Lozenge
  • noNRT Inhaler
  • noVarenicline (Chantix)
  • noBupropion (Zyban)

(Source: North American Quitline Consortium, www.naquitline.org)

American Lung Association Resources

The American Lung Association of Rhode Island 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 401-421-6487 or visit us online at http://www.lungri.org.