State Tobacco Cessation Coverage

Medicaid Coverage

The South Dakota Medicaid program covers:

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

Bupropion (Zyban)
Group Counseling
Individual Counseling

Co-payments of $3 are required for brand name medications (varenicline is only available by the brand name Chantix).

For more information, please call the South Dakota Division for Social Services at 605-773-3495, or visit their website at http://dss.sd.gov/medicalservices/

View Medicaid Coverage Details

State Employee Health Plan Coverage

The South Dakota Bureau of Personnel 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

For more information, please call the South Dakota Bureau of Personnel at 605-334-4000 or 800-831-0785, or visit their website at http://www.bopweb.com/

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 South Dakota Quitline is open 7AM-10PM (M-F), 8AM-5PM (SAT), and 10AM-4PM (SUN) (Central Time). You can reach the South Dakota Quitline by calling 866-SD-QUITS.

American Lung Association Resources

The American Lung Association's Freedom From Smoking® program is widely available in the state of South Dakota. Additional 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 more information call 605-336-7222 or visit us at http://www.lungsd.org

Medicaid Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	No	South Dakota Administrative Rules, 67:16:14:05. Items and services not covered
NRT Patch	No	South Dakota Administrative Rules, 67:16:14:05. Items and services not covered
NRT Nasal Spray	No	South Dakota Administrative Rules, 67:16:14:05. Items and services not covered
NRT Lozenge	No	South Dakota Administrative Rules, 67:16:14:05. Items and services not covered
NRT Inhaler	No	South Dakota Administrative Rules, 67:16:14:05. Items and services not covered
Varenicline (Chantix)	Yes	South Dakota Administrative Rules, 67:16:14:04. Items and services covered
Bupropion (Zyban)	Yes	South Dakota Administrative Rules, 67:16:14:04. Items and services covered
Group Counseling	No
Individual Counseling	No

Type of Barrier	State Has Barrier?	Data Source
Limits on duration	No
Lifetime limit on quit attempts	No
Annual limit on quit attempts	No
Prior authorization required	No
Co-payments required	Yes	Department of Social Services, Medical Assistance Program, Recipient Handbook
Stepped-care therapy	No
Counseling Required for Medications	No
Dollar Limit	No
Other

State Employee Health Plan Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	No	Multiple sources confirm. See Additional Sources below.
NRT Patch	No	Multiple sources confirm. See Additional Sources below.
NRT Nasal Spray	No	Multiple sources confirm. See Additional Sources below.
NRT Lozenge	No	Multiple sources confirm. See Additional Sources below.
NRT Inhaler	No	Multiple sources confirm. See Additional Sources below.
Varenicline (Chantix)	No	Multiple sources confirm. See Additional Sources below.
Bupropion (Zyban)	No	Multiple sources confirm. See Additional Sources below.
Group Counseling	No	Multiple sources confirm. See Additional Sources below.
Individual Counseling	No	Multiple sources confirm. See Additional Sources below.
Phone Counseling	No	Multiple sources confirm. See Additional Sources below.
Online Counseling	No	Multiple sources confirm. See Additional Sources below.
Quit Kit	No	Multiple sources confirm. See Additional Sources below.

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
South Dakota Healthy Employees
ExpressScripts, National Preferred Formulary, 2009
South Dakota Bureau of Personnel, "Tobacco Free Environment Policy: Questions and Answers", May 2006

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

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