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Does Health Insurance Cover Nicotine Patches

Health Dangers From Vaping

Healthcare plan stop-smoking medication coverage

There are similar serious health effects from smoking e-cigarettes, now called vaping, including the highly advertised Juul, from the federal Centers for Disease Control and prevention, also known as the CDC.

  • Most e-cigarettes contain nicotine. Nicotine is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s.1
  • E-cigarettes can contain other harmful substances besides nicotine.
  • Young people who use e-cigarettes may be more likely to smoke cigarettes in the future.

Medicines To Quit Smoking Are A Covered Benefit

You may find medicines and Nicotine Replacement Therapies helpful in your efforts to quit smoking and tobacco use. You may want to choose the nicotine patch, nicotine gum or nicotine lozenge. NRTs may be used along with the prescription medications bupropion or Chantix®.

  • Nicotine Patch, Gum or Lozenge: The nicotine patch, gum or lozenge can be sent directly to you upon request.
  • Bupropion and Chantix® are prescription products. Talk to your doctor to discuss whether bupropion or Chantix® is right for you. If it is, your doctor will give you a prescription.
  • Zyban®, a brand name for bupropion, is a prescription medication which can help ease withdrawal symptoms and the urge to smoke. Bupropion is also used to treat depression. However, you do not have to be depressed to take bupropion for smoking cessation. Bupropion is started while you are still smoking, with your quit-smoking date set for a week later.
  • Chantix® is a prescription medication which can help you stop smoking. You can start taking Chantix® one week before your quit smoking date. You can continue smoking during this time. Most people will keep taking Chantix® for up to 12 weeks. If you have completely quit smoking by 12 weeks, ask your doctor if another 12 weeks of treatment may help you stay tobacco free.

* Medicare members will be responsible for a copay for the smoking-cessation prescription products.

For more information about quitting smoking and tobacco use, the following resources can help:

Remember: You’re Never Too Old To Quit Smoking Or Using Tobacco

When you quit, you can look forward to these health benefits:

3 days: nicotine has left your body

1 year: risk of coronary heart disease cuts in half

2-5 years: risk of mouth, throat, esophagus and bladder cancer cuts in half risk of stroke reduces to that of a non-tobacco user

10 years: half as likely to die from lung cancer risk of kidney or pancreatic cancer decreases

15 years: risk of coronary heart disease drops to a non-tobacco user’s

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Your Options For Quitting

Smokers have many options to help them quit. The more options you use, the better your chances of success. As you review your options, keep in mind how well each will fit into your lifestyle. Your doctor can answer questions. Some quitting medicines require a prescription.

  • Nicotine replacements
  • Bupropion
  • Alternative treatments

Where Can I Get More Information About Medicare Coverage For Smoking Cessation

Quit Smoking Gum Vs Patch

Quitting smoking is never easy, and many people need support in order to succeed. The good news is that, if you are eligible for Medicare, you may have options to help you quit. Id be happy to discuss your Medicare plan options with you if youd like. Want to schedule a phone call or request a personalized email? Click on one of the links below. You can also see a list of plan options you may be eligible for in your area by clicking the Compare Plans button. Click on the View profile link to learn more about me.

For more information about quitting smoking, see:

Quitting Smoking, Centers for Disease Control and Prevention , last modified May 21, 2015,

Reducing Tobacco Use and Secondhand Smoke Exposure: Mobile Phone-Based Cessation Interventions, Guide to Community Preventive Services, last modified April 22, 2016,

New To Medicare?

Becoming eligible for Medicare can be daunting. But don’t worry, we’re here to help you understand Medicare in 15 minutes or less.

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Affordable Care Act: Coverage To Quit Smoking

If you smoke or use any other type of tobacco, now is a great time to talk to your doctor. Under the Affordable Care Act, your health care plan* can give you the tools you need to quit.

Quitting smoking or using any type of tobacco is one of the best things you can do for your health. Tobacco is linked to lung cancer and many other types of cancer, heart disease and stroke, COPD , lung disorders, vision problems, problems during pregnancy, gum disease, and many other serious health concerns. The sooner you stop, the quicker your body can start to recover.

Most health care plans, including all plans purchased through the , cover screening about tobacco use, during which your doctor will ask if you smoke or use tobacco and offer you information on how it affects your health and why you should consider quitting.

Your health care coverage may now include free programs to help you quit. Depending on your plan, that might include:

  • Counseling about how to stop smoking or using other types of tobacco
  • Stop-smoking drugs bupropion and varenicline
  • Nicotine replacement, such as gum, lozenges, skin patch, inhaler, and nose spray

Pregnant women on Medicaid can also receive free counseling and treatment to help them stop smoking or using tobacco.

If you are covered by Medicare, your smoking-related benefits include two opportunities each year to quit smoking or using any other type of tobacco. Each time you try to quit, your Medicare coverage includes:

Insurance Type: State Health Insurance Marketplace Plans

Who’s Covered?

Individuals who buy plans through healthcare.gov or their states marketplace. Subsidies for these plans are available to those earning 100-400% of the federal poverty level.

Required Coverage

  • Tobacco cessation as a preventive service. Federal guidance defines this as:
  • 4 sessions of individual, group and phone counseling
  • 90 days of all FDA-approved smoking cessation medications
  • 2 quit attempts per year
  • No prior authorization for treatments
  • No cost-sharing
  • Individuals who receive health insurance through their employer, association, union or other organization.

    Required Coverage

    • Tobacco cessation as a preventive service. Federal guidance defines this as:
    • 4 sessions of individual, group and phone counseling
    • 90 days of all FDA-approved smoking cessation medications
    • 2 quit attempts per year
    • No prior authorization for treatments
  • No cost-sharing
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    The Effects Of Smoking On Your Health

    Although the health risks associated with smoking are well known, almost 45 million Americans continue to smoke. Quitting smoking is, without a doubt, the single best thing you can do for your health. Every time you smoke a cigarette, you inhale more than 4,000 chemicals. Smoking is a key player in many health conditions, including:

    • Cancer
    • Eye problems

    How Life Insurers Test For Nicotine

    Study suggests nicotine patches could prevent COVID-19 infection

    When youapply for life insurance, youâll be asked if you use tobacco products and when you last used them. That includes cigarettes,vaping, and any smokeless tobacco products. Be honest: If the insurer finds out you lied on your application, thatâsfraud, and they could , cancel an existing policy or refuse to pay the death benefitto your loved ones after you die.

    The next step in theunderwriting process is a paramedical exam, which tests not just for nicotine, but also for cotinine â a byproduct of your body processing nicotine that stays in your blood even after nicotine has left your system.

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    Does Medicare Cover Nicotine Patches

    Quitting a smoking habit is a huge step towards better health and well-being for any tobacco user. Because this can be such a difficult process, nicotine replacement therapies can help satisfy a persons craving for tobacco products and improve their chances of quitting successfully and permanently.

    Understanding How Nicotine Patches Work

    Although there are subtle differences between brands when it comes to dosage strength, patch style and the type of adhesive used to stick the patch to the skin, most nicotine patches work according to the same principle. The body slowly absorbs nicotine into the bloodstream through the skin. Because the tobacco user receives a constant dose of nicotine throughout the day, they can reduce their sense of need for nicotine through smoking.

    Most brands offer a variety of dosage strengths so that the amount of nicotine delivered by a patch can be slowly reduced over time. This may help wean the tobacco user off of their dependence on nicotine without causing them to go through as stark a withdrawal as sudden cessation might cause. Each brand may set its own timeline for when to reduce dosage, but some brands design their NRTs for consumer-directed reduction.

    Instructions for how to wear the patch and for how long may also change between brands, but generally, you can expect to wear a patch for a majority of the day or all day and night if the design of the patch and your tolerance for wearing it permits.

    Medicare Coverage for Nicotine Patches

    Will Chewing Tobacco Show Up On Your Life Insurance Nicotine Test

    Chewing tobacco contains a high amount of nicotine, so if youâre a regular or even occasional user, youâll likely test positive for nicotine or cotinine. Even though you arenât technically smoking, youâll still be assigned a smoker classification because the health risks are similar to cigarette use.

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    How Do I Get Nrts

    You can get NRT products without seeing your doctor. You do not need to be registered for Fair PharmaCare. Visit your local pharmacy. You and the pharmacist must both sign a declaration form.

    Note: You may want to talk to your pharmacist or doctor about whether NRTs are the best choice for you. This is important if you:

    • Are pregnant
    • Are breastfeeding
    • Have any chronic medical conditions
    • Were recently in the hospital
    • Take any regular or prescription medications

    PharmaCare covers two smoking cessation drugs under the smoking cessation program:

  • bupropion , or
  • varenicline generics*
  • See the list of eligible prescription drugs and dosage types at Eligible Smoking Cessation Products.

    You must be registered for Fair PharmaCare or covered by one of the following PharmaCare plans:

    Fair PharmaCare is an income-based planthe less you earn, the more help you get. Registration is free. To find out if you are covered by any of the other plans, you can contact Health Insurance BC.

    Each calendar year , PharmaCare will cover one prescription smoking cessation drug for a single continuous course of treatment. This can be up to 12 weeks .

    *Champix® is now only covered as a partial benefit under PharmaCare. Ask your doctor about the low-cost alternatives.

    What If I Started Or Stopped Smoking After Getting Health Insurance

    Zonnic Nicotine Gum TV Commercial,

    If you change your smoking habits once youve taken out your health insurance policy you should tell your provider.

    Starting to smoke without letting your insurer know may invalidate your policy. Your premium might increase to reflect the greater risk to your health.

    Some insurers will reduce your premium once youve been a strict non- smoker, and not used any nicotine products or replacements, for 12 months in a row. But you may be asked for proof of this.

    Depending on your provider, you might still be charged higher premiums for up to five years after youve stopped smoking.

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    Why You Shouldnt Lie About Your Nicotine Use

    If you lie about your nicotine use, somehow pass the medical screening without it showing up in a nicotine test, and are issued a nonsmoker policy, you could be putting your family at risk.

    The first two years after your policy goes in forceare known as thecontestability period. If you die during that period, the insurance company has the right to go through your medical records and application materials again. If they suspect that you lied about something on your application that affected their ability to insure you â for example, saying you didnât smoke when you actually did â they can cancel your policy.

    This doesnât just apply to the contestability period. Many policies include language that allows providers to deny the death benefit or cancel the policy over fraudulent statements at any time, even past the first two years.

    If you lie on your application, the best-case scenario for yourbeneficiaries is that the provider delays the payment of the death benefit while they investigate. The worst-case scenario is the life insurer declines to pay out at all if your death is deemed tobacco-related.

    What Works Better Nicotine Gum Or Patch

    There was moderate quality evidence that higher dose nicotine patches were more effective than moderate dose patches, but no evidence that double dose patches were more effective. Likewise, there was moderate quality evidence that higher dose gum was more effective, but perhaps only for more dependent smokers.

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    For All Blue Care Network Members

    We encourage all our members who want to quit tobacco to enroll in Tobacco Cessation Coaching. Its available at no extra cost.

    If you’re ready to set a quit date within 30 days, call 1-855-326-5102.Note that if you have prescription drug benefits, you’re eligible for tobacco-cessation aids. These include over-the-counter nicotine replacement products, such as gum, patches or lozenges. Your prescription drug copayment applies.

    For Healthy Blue Living plan members

    Tobacco use is one of the six health areas we measure in our Healthy Blue Living plan.

    To earn enhanced benefits, you need to enroll and actively participate in Tobacco Cessation Coaching.

    If you’re not ready to set a quit date within 30 days, you’re required to enroll in Lifestyle Coaching, powered by WebMD®.Call 1-855-326-5102 to get started in Tobacco Cessation Coaching or Lifestyle Coaching.

    It’s important you enroll within 120 days of the start of your plan year. Otherwise, you’ll be placed at the standard benefit level.

    Youll have to participate in the program until you quit using tobacco. Your primary care physician will test you for tobacco use. If you test positive, youll need to be tested annually.

    To confirm that you’ve stopped using tobacco, please send us a new qualification form signed by your doctor. You may submit the updated form at any time during the plan year. When we receive the updated form, you’ll no longer need to participate in Tobacco Cessation Coaching or Lifestyle Coaching.

    Types Of Quit Medications

    How and When to Use Nicotine Substitutes? – (Nicoderm, Commit, Nicorette, Nicotrol)
    If youve tried one path in the past and it didnt work, consider trying another to help you quit smoking or other tobacco.

    You may have questions about quit medications. Information in this section will help you understand products to help you quit cigarettes, e-cigarettes or other tobacco products.

    Nicotine Replacement Therapy Quit Medications


    Place on the skin. Ideal for long-lasting craving relief. Gradually releases nicotine into your bloodstream. A common brand name is Nicoderm® patch.

    Chew to release nicotine. Helpful way to reduce cravings. Allows you to control your dosage. A common brand name is Nicorette® gum.


    Placed in the mouth like hard candy. Nicotine lozenges offer the same benefits of gum without chewing.

    If you want to quit with nicotine patches and gum or lozenges, there are 3 options for how to get them, how much you get and what it costs:

    1. Sign up with 802Quits and get between 2 and 8 weeks of FREE nicotine patches, PLUS gum or lozenges. Learn more.
    2. If you have Medicaid and a prescription, you can receive unlimited preferred brands of nicotine patches and gum or lozenges or up to 16 weeks of non-preferred brands at no cost to you. Ask your doctor for details.
    3. If you have other medical insurance you may have access to free or discounted NRT with a prescription. Ask your doctor for details.

    Prescription-only Quit Medications

    Cartridge attached to a mouthpiece. Inhaling releases a specific amount of nicotine.



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    Medicare Plans With Prescription Drug Coverage

    If your physician prescribes prescription drugs to help with smoking cessation, please note that Original Medicare coverage of prescription drugs is limited, and generally doesnt cover medications you take at home. A stand-alone Medicare Prescription Drug Plan offered by a Medicare-approved private insurance company can help you cover the costs of prescription drugs. Youll have to check with the plan to make sure that the prescription drugs are on the plans formulary, which is a list of covered prescription drugs. Please note that the formulary may change at any time, and you will receive a notice from your plan when necessary.

    There is another way to receive prescription drug coveragethrough a Medicare Advantage Prescription Drug plan. Some people receive their Original Medicare benefits through an alternative method called a Medicare Advantage plan . The vast majority of Medicare Advantage plans include prescription drug coverage, which may cover certain prescription medications used in smoking cessation. Again, please check the plans formulary.

    What If I’m Covered By Fair Pharmacare

    If you have not met your Fair PharmaCare annual deductible, you will pay the full cost of your prescription, but the drugs eligible cost will count toward your deductible. If you have met your deductible but not your family maximum, PharmaCare covers 70 percent of the eligible cost and you pay the remaining 30 percent. If you have met your annual family maximum, PharmaCare covers 100 percent of the eligible cost.

    FNHA clients

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    What If You Feel Bad When You Are Trying To Quit

    You are likely to crave cigarettes and to have withdrawal symptoms. You may feel grouchy or restless or you may have a hard time concentrating for the first 2 to 3 weeks after you quit. It may be hard to focus on tasks. Or you may have trouble sleeping and want to eat more. But you won’t feel bad forever, and medicine can help. Using medicines and products like nicotine gum or patches can help with cravings and make it easier to resist smoking.

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