Does Medicare Cover Chantix?

Smoking cigarettes can be addictive. And once you get addicted, it is very difficult to break the habit.

Addictive as smoking may be, it causes serious damage to our lungs. Which makes it more difficult for us to breathe and leads to more serious health issues.

Some people turn to medication to help them stop smoking. One popular drug that many smokers try is Chantix. Chantix works by trying to reduce the urge to smoke one more cigarette.

So a common question many people have is, “Does Medicare cover Chantix?” In this article, we answer that question in clear, plain English. You will also find the average costs of Chantix and other helpful info.

The short answer is no. In most cases, Medicare will not cover the cost of Chantix. That said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your Chantix.

Original Medicare

Original Medicare (Medicare Part A and Part B) does not provide coverage for Chantix. Medicare Part B often provides coverage for treatments, therapy, and counseling to help people stop smoking and drinking alcohol. However, that does not include coverage for Chantix.

That is because Original Medicare mainly covers medically necessary services, equipment, and treatments. Chantix does not fall into that category.

However, prescription drug coverage may be provided by either Medicare Advantage plans or by Medicare Part D.

Part C and Part D Coverage for Chantix

Some Medicare Advantage plans (Medicare Part C) provide coverage for Chantix. Medicare Advantage plans cover everything Original Medicare covers as well as offer some additional benefits. However, exactly what they cover and what your out-of-pocket costs are will vary depending on the specifics of your plan.

Medicare Part D plans also provide coverage for Chantix. Chantix is listed as a Tier 3 drug in the Medicare drug formulary. Most of the time Tier 3 medications are preferred branded medications. Tier 3 medications are more expensive than Tier 1 and 2 medications.

How Much Does Chantix Cost?

Chantix typically costs around $10 per tablet. A Chantix starter pack can cost nearly $600 without insurance. The cost can drop to around $450 with insurance.

Information About Chantix

Unlike some smoking cessation aids, Chantix does not contain any nicotine whatsoever. This reduces the risk of craving for a larger amount of nicotine. The manufacturer says this makes it an effective medication. This is especially true with the assistance of proper diet and exercise as well as support from other people.

This medication disrupts the brain’s reaction and cravings to nicotine. Chantix must be taken at least 7 days before your desired quitting day. You need to take it with meals and a full glass of water. Most of the time, you need to take Chantix for up to 12 weeks. But in some cases you make take it for up to 24 weeks.

What Are The Side Effects Of Chantix

Most drugs have some side effects and Chantix is not an exception. Some of the side effects of Chantix may include:

Nausea
Sleep disturbances
Constipation
Vomiting

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.