Cost & Coverage

COST & PAYMENT FOR MEDS

To find the best prices and most convenient pharmacies for your patients, visit goodrx.com and type in the drug’s name.

You’ll even find online coupons and discounts for extra savings.

INSURANCE COVERAGE

There are a number of ways that you, as a healthcare provider, can assist your patients to quit using tobacco. And insurance can help, too. The Affordable Care Act provides helpful benefits for patients who want to quit.

VETERANS

Smoking and tobacco use remain some of the Veteran Affairs’ (VA) biggest public health challenges as many veterans began using tobacco while they were in the military. To help veterans quit, the VA offers:

Screening for tobacco use during primary care visits
Individual counseling
Prescriptions for nicotine replacement therapy (patch, gum or other medications)
Participation in evidence-based smoking cessation programs
Veterans can contact the nearest VA healthcare facility to schedule an appointment. Call toll-free, 1-877-222-8387.

Click here for a list of clinics where veterans can receive services in Utah.

Veterans can also receive intensive personal coaching to help them quit through the Utah Tobacco Quit Line (1.800.QUIT.NOW). In-depth counseling includes up to five sessions lasting 20 minutes each. In addition, up to eight weeks of nicotine replacement therapy (patch or gum) is available to veterans enrolled in this program, and services are provided free of charge to Utah residents up to twice per year.

Utah Quit Line Fax Referral Form

Utah Quit Line Online Referral Form

MEDICARE

CESSATION COUNSELING AND SUPPORT

Nonmedication smoking cessation falls under Medicare Part B (medical) and is covered under doctors’ orders. It includes counseling for two quit attempts during a 12-month period IF the person is diagnosed with a smoking-related illness OR is taking medication that may be affected by tobacco use. Counseling for each attempt includes up to four face-to-face visits.

Co-insurance (usually 20%) and Part B deductible may apply.

CESSATION MEDICATION

Any medication that Medicare covers is covered under Medicare Part D. There are approximately 54 Part D plans and the patient must have a plan that includes cessation medication.

If cessation benefits are not offered through Medicare, patients may receive intensive cessation coaching through the Utah Tobacco Quit Line (1.800.QUIT.NOW). In-depth counseling includes up to five sessions lasting 20 minutes each. Up to eight weeks of nicotine replacement therapy (patch or gum) is available to those enrolled in this counseling program and the services are provided free of charge to Utah residents up to twice per year.

Utah Quit Line Fax Referral Form

Utah Quit Line Online Referral Form

MEDICAID AND PRIMARY CARE NETWORK (PCN)

CESSATION COUNSELING AND SUPPORT

All Medicaid and PCN enrollees are eligible for intensive tobacco cessation counseling through the Utah Tobacco Quit Line (1.800.QUIT.NOW). Intensive counseling includes up to five sessions lasting 20 minutes each. In addition, up to eight weeks of nicotine replacement therapy (patch or gum) is available to those enrolled in the program. These services are provided free of charge to Utah residents up to twice per year.

Utah Quit Line Fax Referral Form

Utah Quit Line Online Referral Form

CESSATION MEDICATIONS

To view the medication benefits for Medicaid and PCN clients, go to Utah Medicaid Benefits.

UTILIZING MEDICAID

All Medicaid clients are eligible for a variety of free services through the Tobacco Quit Line. For those who are ready to quit, intensive cessation counseling and nicotine replacement (patch or gum) are available. For more information, call 1.800.QUIT.NOW.

UTILIZING THE PRIMARY CARE NETWORK

In Utah, the Primary Care Network is part of the Department of Health. PCN clients tend to have higher smoking rates than average, so the Tobacco Prevention and Control Program (TPCP) partners with the PCN to offer quitting services to their clients. The program offers services through the Utah Tobacco Quit Line and includes coverage of tobacco cessation medications, as well as additional help for pregnant women. To learn more, contact TPCP at 1-877-220-3466.

PRIVATE

To view some of the cessation programs offered by Utah health insurance companies, see the Tobacco Cessation Benefits Offered Through Private Insurers chart below:

ALTIUS

For more information, call 1-800-377-4161.

ARCHES HEALTH PLAN

FOR MORE INFORMATION, CALL 1-855-488-0620.

BRIDGE SPAN HEALTH COMPANY

For more information, call 1-855-857-9956.

CIGNA

For more information, see the CIGNA Healthy Rewards discount amenity program at: mycigna.com or call 1-800-Cigna24 (1-800-244-6224)

  • Patch – 50% off of eight-week supply of Habitrol patches, with accompanying self-help guide and CD.
  • 35% off of Quitnet® online tobacco cessation program.
DMBA

FOR MORE INFORMATION, CALL 1-800-777-3622.

HEALTH CHOICE UTAH

FOR MORE INFORMATION, CALL 1-877-358-8797.

HUMANA MEDICAL PLAN OF UTAH INC.

For more information, call 1-800-833-6917.

MOLINA HEALTH CARE OF UTAH

For more information, call 1-801-656-2022.

PUBLIC EMPLOYEES HEALTH PROGRAM (PEHP)

For more information, call 1-800-765-7347.

  • Patch and Gum – fully covered when provided by the Utah Tobacco Quit Line. May self-refer by calling: 1-800-QUIT-NOW. No co-pay or prescription required.
  • Nasal Spray – Nicotrol Nasal Spray covered for up to three months. Prescription and co-pay required.
  • Inhaler – Nicotrol Inhaler covered for up to three months. Prescription and co-pay required.*
  • Bupropion – prescription and co-pay required.*
  • Chantix – available for three months without a prior authorization, but may be dispensed up to six months with a prior authorization. Prescription and co-pay required.*
  • One-on-one telephone support through the Utah Tobacco Quit Line is fully covered. May self-refer by calling: 1-800-QUIT-NOW (1-800-784.8669)
  • Healthy Utah Benefits – Up to $100 rebate incentive for quitting. Contact Healthy Utah for details: 1-801-538-6261 or 1-888-222-2542 or by email: HealthyUtah@utah.gov

*All prescriptions are subject to the pharmacy deductible.

REGENCE BLUE CROSS BLUE SHIELD

For more information, call:
Regence EvolveSM Individual and Family (Core Individual) – 1-866-757-3884
Regence HSA Healthplan 2.0SM and HSA 3.0SM – 1-888-849-0447
Regence ClassicSM, Innova®, Engage® and BluePoint (Core Group) – 1-877-417-6222

Please call the customer service number on the back of your membership card to determine your benefits.

SELECT HEALTH

For more information, call 1-800-538-5038.

Patch – fully covered, but only when provided by Free & Clear.No co-pay or prescription required.
Zyban – covered for up to three months. Prescription and co-pay required.
Chantix – covered for up to six months. Prescription and co-pay required.
Free & Clear telephone counseling. Fully covered. Patients may self-refer by calling 1-866-784-8454.

UNITED HEALTH CARE

For more information, call 1-800-624-2942.

“Quit Power” tobacco cessation program. Check with customer service or myuhc.com for availability.

Smoking Cessation toolkit available to all fully insured employers for use in on-site smoking cessation program. The toolkit includes educational material, tobacco cessation health discount information, a resource guide, nicotine replacement therapy chart and a tobacco cessation tracker.

U OF U HEALTH PLAN

For more information, call 1-888-271-5870.

This web page is for informational purposes only. The accuracy, reliability or completeness of any of the information cannot be guaranteed. If you wish to obtain information about your benefits, contact your health plan directly.

If cessation benefits are not offered through the patient’s health plan, they can receive intensive personal coaching through the Utah Tobacco Quit Line (1.800.QUIT.NOW). In-depth counseling includes up to five sessions lasting 20 minutes each. In addition, up to eight weeks of nicotine replacement therapy (patch or gum) is available to those enrolled in this intensive counseling program and services are provided free of charge to Utah residents up to twice per year.

Utah Quit Line Fax Referral Form

Utah Quit Line Online Referral Form

UNINSURED

Uninsured patients may receive intensive cessation counseling through the Utah Tobacco Quit Line (1.800.QUIT.NOW). Intensive personal coaching up to five sessions lasting 20 minutes each. In addition, up to eight weeks of nicotine replacement therapy (patch or gum) is available to those enrolled in this intensive counseling program and services are provided free of charge to Utah residents up to twice per year.

Utah Quit Line Fax Referral Form

Utah Quit Line Online Referral Form

ASSOCIATION FOR UTAH COMMUNITY HEALTH (AUCH)

Uninsured community health center clients can receive up to 12 weeks of Zyban or 24 weeks of Chantix per year, free of charge, through participating Associations for Utah Community Health (AUCH). Patients receiving cessation medications through the program are referred to the Utah Tobacco Quit Line for counseling.

Click here for a list of community health centers.