Covered and Noncovered Services : Covered Services and Requirements

Tobacco Cessation Drugs

BadgerCare Plus, Medicaid, and SeniorCare cover legend drugs for tobacco cessation.

BadgerCare Plus and Medicaid also cover OTC nicotine gum, patches, and lozenges.

A written prescription from a Medicaid-enrolled prescriber is required for legend and OTC tobacco cessation products. Prescribers are required to indicate the appropriate diagnosis on the prescription. PA is required for uses outside the approved diagnoses indicated on the Diagnosis Restricted Drugs data table.

Tobacco cessation services, as preventive services with an A or B rating from the USPSTF, do not require copayments from any member enrolled in BadgerCare Plus or Medicaid. SeniorCare members are not exempt from copayment for tobacco cessation services.