Chantix is a prescription drug that can help people quit smoking tobacco. Medicare’s prescription drug plans include coverage for certain smoking cessation drugs, including Chantix.
People aged 65 and older, and those under 65 with specific health conditions, are eligible for Medicare coverage.
If a person has original Medicare, parts A and B, they can enroll in a Medicare Part D prescription drug plan (PDP), which is available from a private insurance company as they administer the policies on behalf of Medicare.
Many Medicare Advantage plans include coverage for prescription medication.
Chantix is the brand name for the drug varenicline. Chantix can help reduce the withdrawal symptoms a person may experience when they quit smoking.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
The smoking-cessation drugs include:
- varenicline (Chantix)
- bupropion (Zyban)
- nicotine replacement therapy – nasal spray
- nicotine replacement therapy – inhaler
In addition to smoking cessation drugs, counseling can help people who want to quit smoking.
Medicare Part B covers up to eight counseling sessions over a 12-month period to help someone quit smoking. A person can receive four sessions each time they try to quit smoking, and Medicare covers two attempts per year, the ALA said.
The counseling is free of charge if the person sees a qualified healthcare provider who accepts Medicare.
Those enrolled in Medicare often obtain coverage for prescription drugs such as Chantix through Medicare Advantage or Part D.
Private insurance companies administer Medicare Advantage plans to provide Medicare Part A, inpatient hospital insurance, and Part B, outpatient medical benefits. According to the Kaiser Family Foundation (KFF), in 2020, 90% of Medicare Advantage plans included prescription drug coverage.
Alternatively, someone who has original Medicare parts A and B may enroll in a Part D PDP from a private insurance company.
Medicare sets a basic level of coverage for the drug plans, and all the plans must cover the same medication categories, according to Medicare.gov. The amount someone pays for a particular drug will vary depending on their plan.
Chantix is one of several prescription drugs that may help someone quit smoking. Researchers believe that Chantix works by interacting with nicotine receptors in the brain. According to the American Cancer Society (ACS), varenicline may reduce the pleasure someone feels when smoking. It may also decrease nicotine withdrawal symptoms.
The ACS recommends that people who are very dependent on nicotine think about using a drug such as Chantix to help them quit. An individual might be considered severely dependent on nicotine if they smoke one pack of cigarettes or more a day.
Additional symptoms of severe nicotine dependence include:
- waking up to smoke during the night
- smoking a few minutes after waking up
- smoking while sick
- feeling withdrawal symptoms when not smoking
Healthcare providers typically prescribe a 12-week supply of varenicline pills to people who want to quit smoking, said the ACS. In some cases, a person may receive a second 12-week prescription.
An individual who has decided to stop smoking usually begins taking varenicline 1 week to a month before their quit day.
A generic version of Chantix is not yet available in the United States. Other medications may be an option for people who want to quit smoking, and discussing this with a primary care physician might help.
Bupropion is an alternative prescription drug that may help people quit smoking. It goes by the brand name Zyban and is also available as a generic option. The drug may help reduce nicotine cravings and withdrawal symptoms.
For best results, people should start taking bupropion 1–2 weeks before they quit smoking, said the ACS.
Nicotine replacement therapy
Someone who wants to quit smoking may also reduce withdrawal symptoms through nicotine replacement therapy (NRT).
According to the ACS, a person should use NRT only after they have stopped smoking cigarettes and using other tobacco forms.
Nicotine sprays and inhalers require a prescription. Some other forms of NRT are available without a prescription and can be purchased over-the-counter, including:
- nicotine gum
Medicare typically does not pay for non-prescription drugs.
When a generic version of Chantix becomes available, people taking the drug may save money by using the generic option rather than the brand-name.
According to Medicare, generic drugs are the same as their brand-name equivalents in their active ingredients, dosage, safety, and quality.
Medicare drug plans often sort drugs into different categories, known as tiers. A person might pay higher out-of-pocket costs for drugs in higher tiers, and generic versions are often in a lower tier, with a smaller cost.
According to the U.S. Surgeon General, more than half of adults who smoke try to quit each year.
Smoking cessation drugs and behavioral counseling improve the chances that someone will be able to quit smoking, especially if a person uses drugs and counseling together, the
- choosing a quit date
- thinking about reasons for quitting
- calculating savings from quitting
- recognizing triggers for smoking
- having a plan to fight cravings
- assembling support such as friends or family
Smokefree.gov offers additional help for people who are trying to quit smoking by:
Those with a limited income may be eligible for assistance with their prescription drug costs through a Medicare program called Extra Help. To qualify for Extra Help, a person must:
- be enrolled in Medicare
- have limited income and resources
- live in one of the 50 U.S. states or the District of Columbia
In addition, Medicare offers resources on its website that may help with drug costs.
Smoking cessation is an important step that people can take to improve their health.
Prescription drugs such as Chantix may make it easier for someone to quit smoking tobacco, especially if the person is very dependent on nicotine.
Medicare drug plans can help cover the costs of Chantix and other smoking-cessation medications.