State Tobacco Cessation Coverage

Medicaid Coverage

The Texas 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 50 cents for generic and $3 for brand names are required, except for pregnant women. Coverage of counseling varies by health plan.

For more information, please call the Texas Medicaid Program at 877-541-7905, or visit their website at http://www.hhsc.state.tx.us/medicaid/index.html

View Medicaid Coverage Details

State Employee Health Plan Coverage

The Group Benefits Program covers:

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

Bupropion (Zyban)
Group Counseling
Individual Counseling
Phone Counseling

Members of the HealthSelect plan can receive telephone or internet counseling (visit http://www.bcbstx.com/hs/pdf/tobaccocessationhs.pdf for more information). Members of the Scott and White plan can receive online counseling at https://my.healthmedia.com/index.html?b=ok&au=tgbp.

For more information, please call the Texas Employee Group Benefits Program at 512-867-7711 or 877-275-4377, or visit their website at http://www.ers.state.tx.us/insurance/default.aspx

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 Texas Quitline is open 6AM-11PM (M-TH), 6AM-8PM (FRI), 8AM-6PM (SAT-SUN) (Central Time). You can reach the Texas Quitline by calling 877-937-7848.

American Lung Association Resources

The American Lung Association's Freedom From Smoking® program is available in limited locations in Texas. Not On Tobacco is offered in select high schools in Texas. 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 about program locations and schedules, call 512-467-6753 or visit us online at http://www.texaslung.org

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	Yes	Texas Medicaid, Formulary Drug Search
NRT Patch	Yes	Texas Medicaid, Formulary Drug Search
NRT Nasal Spray	No	Texas Medicaid, Drug Formulary Search
NRT Lozenge	No	Texas Medicaid, Drug Formulary Search
NRT Inhaler	No	Texas Medicaid, Formulary Drug Search
Varenicline (Chantix)	Yes	Texas Medicaid, Formulary Drug Search
Bupropion (Zyban)	Yes	Texas Medicaid, Formulary Drug Search
Group Counseling	Varies	Texas Health & Human Services Commission, Uniform Managed Care Contract Terms & Conditions, Version 1.13
Individual Counseling	Varies	Texas Health & Human Services Commission, Uniform Managed Care Contract Terms & Conditions, Version 1.13

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	Texas Medicaid, Formulary Drug Search
Co-payments required	Yes	Texas Health and Human Services Commission, "HHSC Announces the Implementation of Medicaid Copayments Beginning December 16, 2002"
Stepped-care therapy	No
Counseling Required for Medications	No
Dollar Limit	Yes
Other

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

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

Texas

Medicaid Coverage

State Employee Health Plan Coverage

Private Insurance Coverage

Quitline

American Lung Association Resources

Medicaid Data Sources

State Employee Health Plan Data Sources

Private Insurance Coverage Details

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	No	Multiple sources. See Additional Sources below.
NRT Patch	No	Multiple sources. See Additional Sources below.
NRT Nasal Spray	No	Multiple sources. See Additional Sources below.
NRT Lozenge	No	Multiple sources. See Additional Sources below.
NRT Inhaler	No	Multiple sources. See Additional Sources below.
Varenicline (Chantix)	No	Multiple sources. See Additional Sources below.
Bupropion (Zyban)	No	Multiple sources. See Additional Sources below.
Group Counseling	No	Multiple sources. See Additional Sources below.
Individual Counseling	No	Multiple sources. See Additional Sources below.
Phone Counseling	Varies	Employee Retirement System of Texas, HealthSelect, Blue Cross Blue Shield of Texas, "Tobacco Cessation"
Online Counseling	Varies	Multiple Sources. See Additional Sources below.
Quit Kit	No	Multiple sources. See Additional Sources below.