Will Medicare pay for Chantix?

Does Medicare cover Chantix? While traditional Medicare might not cover the smoker-quitting drug, that doesn’t mean you don’t have options. Some compatible Medicare Part C plans will be able to offer you coverage on Chantix. In addition, Medicare health insurance does cover up to eight counseling sessions per year to help you stop smoking.

Now that you know Medicare doesn’t cover Chantix enter your ZIP code into our free quote tool to see what you could pay for a policy that does.

When does Medicare pay for Chantix?

Medicare is a service that helps those over 65 save on medical and prescription costs. But, do those savings extend to the tobacco quitting drug Chantix? While this drug has been shown to help people experiencing withdrawal symptoms for smoking, whether it’s covered or not will likely depend on your insurance.

Like most health insurance programs, Medicare puts a lot of weight on preventing more severe illnesses. Since cigarettes are linked to diseases like cancer, Medicare offers services to help its customers save. Medicare Advantage plans may cover a variety of prescription smoking-ceasing drugs like:

• varenicline – Chantix
• bupropion – Zyban
• nicotine replacement therapy – nasal spray or inhaler

With these tools, you should have a much easier time dealing with the side effects when you stop smoking tobacco. In addition to these drugs, Medicare also offers up to eight counseling sessions per year to help you deal with the urge to stop smoking.

Which Medicare Parts could cover Chantix?

Medicare insurance is currently split into four parts that cover different charges in medicine. These designations make it easier to file claims and understand what’s covered where. These four Parts of Medicare include:

• Part A – covers inpatient hospital stays and associated costs while you’re there
• Part B – Outpatient services that are deemed medically necessary or preventative
• Part C – Medicare Advantage allows the program to partner with private insurance companies to offer extended coverage
• Part D – Part D covers prescription drug costs and vaccines

While you might imagine Medicare would cover Chantix under Part D, you’ll need a Medicare Advantage plan. Traditional Medicare doesn’t cover drugs like Chantix, so you’ll need to go through a compatible Part C provider that covers those drugs that help you quit smoking.

How much does Chantix cost without insurance?

How much is Chantix? The reason that you’re likely looking for help paying for Chantix is due to the high cost associated with the medicine. Using GoodRx, some of the prices across retailers for the drug include:

• Kroger Pharmacy – $350.79
• Walgreens – $205.55
• CVS Pharmacy – $376.55
• Walmart – $389.35
• Publix – $377.45

As you can see, this drug is nearly $400 at most retail companies for 60 1mg tablets. So it’s wise to find an insurance company to help you cover those costs. Otherwise, you’ll be paying hundreds of dollars each time you need a resupply.

While Medicare might not traditionally cover this medicine, you can get a Medicare Advantage plan that can help. How much it covers will likely depend on your plan, but at least you won’t pay $400 for a single supply of Chantix.

What is the Chantix cost with insurance?

According to Healthline, Chantix with the right insurance plan can cost as low as $10 per supply, depending on your prescription drug plan. This is a considerable difference in price if you can find an insurance company willing to offer the prescription at that price.

Health insurance companies will always prefer that you prevent an illness before you have to treat it, including the diseases associated with smoking. Therefore, some insurance companies likely view Chantix and other similar drugs as preventative measures in the long run.

What is Chantix used for?

Chantix is a medicine known to reduce the side effects for people who’ve stopped smoking cigarettes. However, since the process can be difficult, anything that offsets cravings and other symptoms is welcomed. While taking Chantix, it’s recommended that you also attend support and education groups to better your chance of success.

The successful cessation of smoking will lower lung and heart disease, prolonging your life and lowering what your insurance will pay later.

Does Medicare offer other options to quit smoking?

Medicare offers a variety of preventative services meant to help individuals before there is a severe illness or injury. In addition, Medicare offers various physical and mental health services intended to prevent the worst. Those services include up to eight counseling sessions per year to help you stop smoking.

During those counseling sessions, you’ll be educated on what your body is going through and how to prepare and deal with some of the symptoms. This can also help you understand your feelings and responsibly deal with your cravings.

Case Studies: Medicare Coverage for Chantix

Case Study 1: John Doe

John Doe is a Medicare beneficiary who wants to quit smoking and has been prescribed Chantix by his healthcare provider. However, John is unsure whether Medicare will cover the cost of this medication. After consulting with his Medicare Part D plan, John discovers that Chantix is indeed covered under his plan’s formulary. As a result, he only has to pay a copayment for each prescription refill.

Case Study 2: Jane Smith

Jane Smith is also a Medicare beneficiary seeking assistance in quitting smoking. Like John, she has been prescribed Chantix by her doctor. However, Jane’s Medicare Advantage plan does not include Chantix on its formulary. In this case, Jane decides to explore alternative options and discusses potential alternatives with her healthcare provider, such as nicotine replacement therapy.

Although Chantix is not covered by her plan, Jane successfully finds a covered alternative that meets her needs.

Case Study 3: Robert Johnson

Robert Johnson is a Medicare beneficiary with a standalone Medicare Part D prescription drug plan. He wants to use Chantix to quit smoking, but upon reviewing his plan’s formulary, he discovers that Chantix is not included. Robert is determined to pursue this treatment and decides to file an exception request with his plan.

After providing supporting documentation from his healthcare provider, Robert’s exception request is approved, and his plan agrees to cover Chantix for him.

Case Study 4: Sarah Thompson

Sarah Thompson, a Medicare beneficiary, has Original Medicare (Parts A and B) but does not have a prescription drug plan. She also wants to quit smoking and has been prescribed Chantix. Since Original Medicare does not cover prescription medications like Chantix, Sarah decides to enroll in a standalone Medicare Part D plan.

After selecting an appropriate plan that includes Chantix on its formulary, Sarah is able to obtain coverage for the medication.

Medicare Paying for Chantix: The Bottom Line

Does Medicare cover Chantix? Like a lot of Medicare coverage, it depends. If you’re looking for traditional Medicare to cover the Chantix cost, you’ll be disappointed. However, Medicare Advantage plans will cover the Chantix price, some as low as $10 per supply. Medicare also offers counseling services to help you quit smoking.

Now that you know that Medicare doesn’t cover Chantix, you can enter your ZIP code into our free quote tool to see what you’d pay with a company that does.