Comprehesive Cessation Coverage

Supporting Louisiana Quitters

Louisiana Employers Should Provide Comprehensive Cessation Coverage

Well-Ahead Louisiana is committed to moving Louisiana’s health forward, and a big part of that goal is achieving a tobacco-free state for all our residents. In order to do that, it’s crucial that we provide the support and resources needed for Louisiana residents to quit tobacco for good.

Louisiana provides a Quitline for all residents to receive free tobacco cessation support, but employers have the opportunity to do more by providing comprehensive cessation coverage through health plans.

What Tobacco Cessation Coverage is Required?

The Patient Protection and Affordable Care Act (ACA) requires most health insurance plans to cover comprehensive tobacco cessation benefits as a preventive service.1 In 2014, The U.S. Departments of Health and Human Services, Labor and Treasury issued guidance on insurance coverage of tobacco cessation. Health insurance must cover two quit attempts per year, consisting of:2
  • Four sessions of individual, group and phone counseling.
  • 90 days of all FDA-approved smoking cessation medications.
  • Barrier-free access—no cost-sharing or prior authorization for treatments.
Health insurance plans required to cover comprehensive tobacco cessation, without cost-sharing:2
  • Private group plans (large and small groups) that are not grandfathered
  • Individual private plans that are not grandfathered
  • Plans offered through State Health Insurance Marketplaces
  • Alternative Benefit Plans (i.e., plans offered to the Medicaid expansion population)
Health insurance plans recommended to cover comprehensive tobacco cessation:2
  • Medicare
  • Standard Medicaid plans
  • Grandfathered Private Health Plans—must have been in existence before March 23, 2010 and have not made any significant changes to coverage or structure since then.3

Effective Cessation Treatment

According to the U.S. Public Health Service (PHS) Clinical Practice Guidelines,1 effective cessation treatment includes barrier-free access to all approved tobacco cessation medications as well as individual, group and telephone counseling. Louisiana residents are more likely to quit successfully if their healthcare plan coverage does not impose barriers to care.1 Ultimately, this public health intervention will save money and lives.

Counseling

The most successful cessation treatments combine cessation medications with some form of counseling.2 Effective cessation counseling incorporates social support, addresses practical coping and teaches residents who use tobacco problem-solving skills.2 As intensity of treatment increases, so does effectiveness.2

There are many different ways to receive tobacco cessation counselling, including in-person individual and group sessions, over the phone, through texting and even on apps and online chats. Residents should have the ability to choose what works best for them. Both private and public health plans can utilize Louisiana Quitline services for cessation counseling and medications.

Medications

A comprehensive tobacco cessation benefit includes coverage of all types of cessation medications. There are seven forms of cessation medications approved by the FDA.1

  • Nicotine patch
  • Nicotine gum
  • Nicotine lozenge
  • Nicotine inhaler
  • Nicotine nasal spray
  • Bupropion (Zyban & Wellbutrin)
  • Varenicline (Chantix)

Taking a Step Further

Well-Ahead works with employers to support their employees in living life tobacco-free. We can assist employers with altering or expanding cessation coverage to offer more comprehensive benefits to employees. Organizations can also participate in our WellSpot Designation program to implement additional health and wellness changes, including tobacco related strategies such as establishing a tobacco-free policy and promoting Quit With Us, Louisiana, the Louisiana Quitline.

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Citations

1Tobacco Cessation. United States Preventive Services Task Force, 2014. Retrieved from https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions

2Tobacco Cessation Treatment: What Is Covered?, 2020. Retrieved from https://www.lung.org/policy-advocacy/tobacco/cessation/tobacco-cessation-treatment-what-is-covered

3Kaiser Health News. FAQ: Grandfathered Health Plans https://khn.org/news/grandfathered-plans-faq/