University of Michigan
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June 16, 2019

Program offers zero copay for smoking-cessation medications

June 2, 2014

Program offers zero copay for smoking-cessation medications

According to the Centers for Disease Control and Prevention, covering tobacco cessation treatments is one of the most cost-effective health insurance benefits that an employer can provide to its employees.

U-M employees and their benefits-enrolled spouses/other qualified adults (OQA) looking for help quitting tobacco can now get select prescription and over-the-counter (OTC) tobacco-cessation medications with no copay. This coverage complies with the preventive care services provisions required under the Affordable Health Care Act. 

Research indicates that medications and counseling are both effective for treating tobacco dependence, and using them together is even more effective than using either alone.

To receive the zero copay, the employee or benefits-enrolled spouse/OQA must be covered under the U-M Prescription Drug Plan and have a doctor's prescription (required for prescription medications) or be enrolled in an MHealthy Tobacco Consultation Service (TCS) approved tobacco treatment program.

Covered generic OTC nicotine replacement products include the generic nicotine patch, generic nicotine gum, and generic nicotine lozenge. Brand name OTC products are not covered. Covered prescription medications include nicotine inhaler, nicotine spray, bupropion (generic for Zyban), and Chantix (varenicline).

“Most people who are smokers want to quit but may not know where to start or are worried about not being able to quit,” says Lena Gray, a TCS health educator.

“Our program offers help without judgment or scare tactics. We assess your current tobacco use and match your needs to the nicotine replacement product that might work best for you. We also help you overcome the behavioral component, which is a big part of quitting tobacco for good.”

TCS provides employees and benefits-enrolled spouses/OQAs confidential, free counseling to help quit tobacco. Participation can be in-person, over the phone, or online, and in group or individual formats.

To get coverage for OTC nicotine replacement products, a TCS tobacco treatment specialist will provide an authorization letter that must be presented to the pharmacy. Participants that complete their program may also qualify for a $100 before-tax incentive.

Tags: MHealthy