Wellcare Dual Align (HMO D-SNP): Smoking and Tobacco Use Cessation (Counseling to stop)

Tobacco use causes cancers throughout the body, not just in the lungs of smokers. Tobacco users spend $70 per week ($280/month) on tobacco products.

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Cost
$0 for those without tobacco-related disease; Cost-sharing for those with tobacco-related disease
Prior Authorization Required
No
Provider Referral or Order Required
No

How To Receive

Details on how to apply

If you use tobacco, but do not have signs or symptoms of tobacco-related disease: The Plan covers two counseling quit attempts within a 12-month period as a preventive service with no cost to you. Each counseling attempt includes up to four face-to-face visits.


If you use tobacco and have been diagnosed with a tobacco-related disease or are taking medicine that may be affected by tobacco: The Plan covers cessation counseling services. The Plan covers two counseling quit attempts within a 12-month period; however, you will pay the applicable cost sharing. Each counseling attempt includes up to four face-to-face visits.


Find a program

Use quitlines to find State programs in all 50 states and the District of Columbia. Quitlines also have highly trained quit coaches available.

Call the CDC Quitline (800) 784-8669

Call the American Lung Association Lung Helpline (800) 586-4872

Call the National Cancer Institute Smoking Quitline (877) 448-7848

Call the American Cancer Society (800) 227-2345

Note that the quitlines are NOT a substitute for a clinical smoking cessation program, they serve as an additional layer of help.

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Up to 8 smoking and tobacco-use cessation (quit) counseling sessions within 12 months for tobacco users who do not have signs or symptoms of tobacco-related disease (such as those associated with COPD, and oral, tracheal, or lung cancer).

For those who use tobacco and have been diagnosed with a tobacco-related disease or are taking medications that may be affected by tobacco, cessation counseling is also available. Still, it requires that applicable cost-sharing be paid by the member.  This benefit is not free in this case.

Each counseling attempt includes up to 4 face-to-face visits. Successful intervention for smoking and tobacco cessation begins with identifying users and appropriate interventions based on their willingness to quit.

You may hear about many options for cessation, including breaking it down into three or five steps (sometimes called “The 3 As” or “The 5 As” and sometimes “The 5 Rs”).  Regardless of which option is presented or chosen, cessation therapy always begins with psychological-behavioral methods before introducing the more invasive nicotine replacement therapy (gum, patches), and anti-smoking medication is usually a last resort because it can produce unpleasant side effects.

"Going cold turkey” (quitting abruptly altogether) and self-guided use of over-the-counter nicotine replacement products have a high failure rate because there is no concentration on or support for real behavior change, which is the biggest driver for smoking and tobacco use.  In other words, while nicotine is certainly addictive, smoking and tobacco use are mostly habitual.  Some examples:

Routines and behavior patterns must be addressed for cessation to succeed. Understand that it typically takes MANY quit attempts before quitting is actually achieved.

CDC

The CDC also offers smoking cessation support. Call the quitline: 1-800-QUIT-NOW (1-800-784-8669) or visit How to Quit Smoking. Quitlines provide free and confidential coaching to help you become—and stay—smoke-free. Calling a quitline might be just what you need to help you quit for good.

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