State Tobacco Cessation Coverage

Medicaid Coverage

The Vermont Medicaid program covers:

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

Bupropion (Zyban)
Group Counseling
Individual Counseling

NRTs are limited to 8 weeks per quit attempt, and varenicline and bupropion are limited to 12 weeks per attempt. Prior authorization is required for treatment beyond these limits. Two attempts per year are covered. Co-payments of $1-3 are required.

For more information, please call the Green Mountain Care Office at 800-250-8427, or visit their website at http://www.greenmountaincare.org/about/green_mountain_care_programs.html#medicaid

View Medicaid Coverage Details

State Employee Health Plan Coverage

State employee benefits in Vermont cover:

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

Bupropion (Zyban)
Group Counseling
Individual Counseling
Phone Counseling

Standard copays apply.

For more information, please call the Vermont Department of Human Resources Employee Service Center at 802-828-0709, or visit their website at http://www.vermontpersonnel.org/employee/index.php

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 Vermont QuitLine is open 7AM-11Pm (M-TH), 7AM-8PM (FRI), 9AM-7PM (SAT-SUN) (Eastern Time). You can reach the Vermont Quitline by calling 877-937-7848.

American Lung Association Resources

The American Lung Association of Vermont 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 802-876-6500 or visit us online at http://www.lungvt.org

Medicaid Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	Yes	Preferred Drug List
NRT Patch	Yes	Preferred Drug List
NRT Nasal Spray	Yes	Preferred Drug List
NRT Lozenge	Yes	Preferred Drug List
NRT Inhaler	Yes	Preferred Drug List
Varenicline (Chantix)	Yes	Preferred Drug List
Bupropion (Zyban)	Yes	Preferred Drug List
Group Counseling	No
Individual Counseling	No

Type of Barrier	State Has Barrier?	Data Source
Limits on duration	Yes	Office of Vermont Health Access, Pharmacy Benefit Management Program, April 1, 2008, Clinical Criteria Manual
Lifetime limit on quit attempts	No
Annual limit on quit attempts	No	Office of Vermont Health Access, Pharmacy Benefit Management Program, April 1, 2008, Clinical Criteria Manual
Prior authorization required	Yes	Office of Vermont Health Access, Pharmacy Benefit Management Program, April 1, 2008, Clinical Criteria Manual
Co-payments required	Yes	Office of Vermont Health Access, Agency of Human Services, November 2007, OVHA Pharmacy Programs
Stepped-care therapy	No
Counseling Required for Medications	No	Office of Vermont Health Access, Pharmacy Benefit Management Program, April 1, 2008, Clinical Criteria Manual
Dollar Limit	No
Other

Additional Data Sources
OVHA Pharmacy Bulletin, February 2007, "Smoking Cessation Therapies to be Added as Managed Drug Classes on PDL Effective 03/01/07"

State Employee Health Plan Data Sources

Type of Treatment	State Covers Treatment?	Data Source
MCO's Control Meds Coverage?
NRT Gum	Yes	Correspondence with State of Vermont, Employee Benefits Unit
NRT Patch	Yes	Correspondence with State of Vermont, Employee Benefits Unit
NRT Nasal Spray	Yes	Correspondence with State of Vermont, Employee Benefits Unit
NRT Lozenge	Yes	Correspondence with State of Vermont, Employee Benefits Unit
NRT Inhaler	Yes	Correspondence with State of Vermont, Employee Benefits Unit
Varenicline (Chantix)	Yes	Correspondence with State of Vermont, Employee Benefits Unit
Bupropion (Zyban)	Yes	Correspondence with State of Vermont, Employee Benefits Unit
Group Counseling	No	Vermont Department of Human Resources, "Vermont's Quit Smoking Services"
Individual Counseling	No	Vermont Department of Human Resources, "Vermont's Quit Smoking Services"
Phone Counseling	No	Vermont Department of Human Resources, "Vermont's Quit Smoking Services"
Online Counseling	No	Vermont Department of Human Resources, "Vermont's Quit Smoking Services"
Quit Kit	No	Vermont Department of Human Resources, "Vermont's Quit Smoking Services"

Type of Barrier	State Has Barrier?	Data Source
Limits on duration	No	Correspondence with State of Vermont, Employee Benefits Unit
Lifetime limit on quit attempts	No	Correspondence with State of Vermont, Employee Benefits Unit
Annual limit on quit attempts	No	Correspondence with State of Vermont, Employee Benefits Unit
Prior authorization required	No	Correspondence with State of Vermont, Employee Benefits Unit
Co-payments required	Yes	Correspondence with State of Vermont, Employee Benefits Unit
Stepped-care therapy	No	Correspondence with State of Vermont, Employee Benefits Unit
Counseling Required for Medications	No	Correspondence with State of Vermont, Employee Benefits Unit
Dollar Limit	No	Correspondence with State of Vermont, Employee Benefits Unit

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

Stop Smoking

Lung HelpLine

E-Newsletter

Vermont