Medicaid Coverage

The Rhode Island Medicaid program covers:

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

NRT gum, patch, lozenge, inhaler, nasal spray, bupropion and Chantix are covered by all health plans. Chantix is covered by some plans. Individual and group counseling are covered by all plans. Coverage limitations, including limits on duration and quit attempts, prior authorization, step therapy and counseling requirements, vary by plan.

For more information, please call the Rhode Island Department of Human Services at 855-697-4347, or visit their website at http://www.eohhs.ri.gov/Home.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 Tobacco Cessation Program covers:

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

All types of medication and counseling are covered. There is a duration limit of two months for medications and eight counseling sessions. Counseling is required 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; 1-800-879-8678; https://ri.quitlogix.org/

Hours: 7:00 AM - 1:00 AM Monday-Sunday

Eligibility to recieve counseling: Resident of state. For medication: resident of state, age 18+, no medical conditions preventing use.

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 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.