Tobacco Cessation ProgramTobacco Cessation Program

MUS - TOBACCO CESSATION PROGRAM GUIDELINES

Effective July 1, 2010, the Tobacco Cessation program is offered to tobacco users who want to quit, and are insured with the MUS Employee Health plan.

Guidelines:

  1. This is a once in a lifetime, one year benefit.  Participants have one year from the date they start this program to use this benefit.  Expenses that occur prior to approval or after one year will not be covered.
  2. Participants will coordinate this benefit with the Program Manager from the MUS Benefits office, or another Benefits office employee.
  3. Participants must use the Montana Tobacco Quit Line (QL) telephone tobacco cessation coaching at least once per month during the duration of this benefit.  Twice per month is the participant is taking Chantix.
  4. As requirements are met, the benefit assists with pre-authorized, in-network expenses for tobacco cessation related medical services and/or prescriptions billed through the MUS Health Benefit and Pharmacy plan.
  5. The number of plan dollars available through this benefit is limited and usage will be closely monitored by the Program Manager, who will work with you to determine the best course of action for your success.

Optional Products and Services:

  1. Appointments with in-network health care providers for tobacco cessation for up to four tobacco cessation related visits.  Traditional plan members are responsible for the co-insurance portion of the appointment, the deductable is waived.  Managed Care plan members are responsible for the appointments co-pay.
  2. Face to face tobacco cessation related counseling.   Four initial free visits with an in-network provider are authorized.  Four additional visits can be authorized by the Program Manager if more counseling is desired.  Refer to the benefit in your Choices workbook for program benefits and limitations.
  3. For Plan members 18 years and older with a prescription:
  1. Over the counter (OTC) nicotine replacement therapy (NRT), if the four weeks provided by the QL is used first.  Up to four additional weeks can be authorized. (Includes:  patches, gum or lozenges)
  2. Chantix.  The member is responsible for the first three $50 co-payments through the QL, after which the benefit covers up to three additional months.
  3. Bupropion.  The member is responsible for the first three months $5 co-payments through the QL, after which the benefit covers the duration of the one year Tobacco Cessation benefit period if needed.
  4. Medication prescribed to assist with Tobacco Cessation  (Wellbutrin and Zyban only)

*All medications, including OTC, must be purchased through a pharmacy to utilize the URx prescription plan. 

IF you are ready to quit tobacco and are willing to comply with the program guidelines, please continue on to complete the Tobacco Cessation Program contract!

TOBACCO CESSATION FORMS

Tobacco Cessation Contract

Contact:
Carol Franco
Montana University System
2500 Broadway, Helena, MT  59601
1-877-501-1722

 

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