Tobacco Cessation resources are also available to you and your enrolled dependents under the SCL Health Medical Plans.
Cigna Plan Members:
Through your Pharmacy benefit, all brands of nicotine patches, gum and lozenges are covered at no charge to you with a prescription. In addition, up to two 90-day treatments of bupropion (generic for Zyban) are also covered at 100%. Brand name medications (Zyban and/or Chantix) are not covered at 100% under the plan and will be subject to plan deductible and coinsurance or copayment requirements like other brand medications covered by the plan. It may be possible to obtain 100% coverage for these medications, but only if your physician determines that the over-the-counter and generic treatments are medically inappropriate (e.g., you have tried these forms of cessation and failed or have a negative reaction to them).
Under the Medical benefit, without a prescription, all brands of nicotine patches, gum and lozenges are covered at no charge to you up to a total annual limit of $300.
Kaiser Permanente Plan Members:
The SCL Health Kaiser Permanente EPO plan covers the prescription drug bupropion (generic for Zyban) for smoking cessation at no cost to you. Your plan also covers over-the-counter (OTC) smoking cessation products (nicotine patch, gum, lozenges) at no cost. For the prescription drug and OTC items, you will need a prescription from your KP provider that can be filled at a KP pharmacy. Other resources available at no cost to you include Kaiser’s online webinars and program as well as HealthMedia Breath.