Insurance Coverage for Tobacco Cessation Treatments
Why is Insurance Coverage of Tobacco Cessation Important?
Despite increased public awareness of risk factors associated with tobacco abuse, tobacco use is the leading cause of preventable death in the United States and worldwide. According to the CDC, more than 16 million Americans are living with a disease caused by smoking. Worldwide, tobacco use causes more than 7 million deaths per year. If the pattern of smoking all over the globe doesn’t change, more than 8 million people a year will die from diseases related to tobacco use by 2030. According to the 2016 Surgeon General Report “As cigarette smoking among those under 18 has fallen, the use of other nicotine products, including e-cigarettes, has taken a drastic leap. All of this is creating a new generation of Americans who are at risk of nicotine addiction.”
With increased marking tactics targeting teenagers and young adults the risks of our youth developing nicotine addictions is only increased. Almost 90 percent of adult smokers became addicted to tobacco products at or before age 20. The 2017 NC Youth Tobacco Survey found that while cigarette smoking continues to decrease among middle and high school students in North Carolina, e-cigarette use is increasing to epidemic proportions, which is increasing the overall tobacco use rate among teens. Evidence shows that tobacco cessation benefits help people quit smoking and that quit rates are higher when health insurance covers this benefit. People are more able to utilize tobacco cessation services when they do not have to pay for expensive treatment out of pocket.
Status of Insurance Coverage and Coverage Gaps
The Affordable Care Act (ACA) and other federal laws and rules require most health insurance plans in the U.S. to cover some level of tobacco cessation treatments. The following chart gives details of these requirements. Note that information on this chart does not guarantee coverage for certain treatments in any insurance plan – policymakers and regulators must enforce these requirements and insurance plans and employers must implement them. Patients should check with their plan to confirm which treatments are covered.
All public and private health care coverage include a comprehensive tobacco cessation benefit with access to all three types of counseling and all FDA-approved medications, without cost-sharing to the patient or other barriers, for all enrollees.
While federal law has been effective in increasing coverage of tobacco cessation services for pregnant women on Medicaid and enrollees in most private insurance and Medicaid expansion plans, there are still gaps in coverage, particularly when it comes to enrollees in traditional Medicaid plans.
Requiring all plans to provide a comprehensive tobacco cessation benefit and without barriers is key to helping people quit tobacco use. Ultimately this public health intervention will save lives.
Are you, or someone you love, ready to quit using tobacco?
Here are some community tobacco cessation programs available to the public
QuitlineNC - North Carolina has a free Quitline, which offers telephone counseling to help people quit smoking and/or quit using tobacco products. Call 1-800-QUIT-NOW or visit their website at quitlinenc.com.
Durham County Health Department - Bull City Breathes Program which offers free tobacco cessation classes and support services. Call 919-560-7600 or visit their website Bull City Breathes.
Quit at Duke is Duke’s Smoking Cessation Program that offers tobacco cessation medication management, research, counseling, and classes. Call 919-613-QUIT (7848) or visit their website for more information Dukehealth.org/quit.