Quitting Smoking Not "Medically Necessary"????

Question

I'm a smoker (soon to be ex-smoker, I hope) who has smoked for more than 20 years. I'm ready to quit and I want and need to quit.

However, my insurance refused to cover a prescription for Chantix, saying that is was not "medically necessary". Huh. Okay...whatever...I paid for it myself, which cost over $120.

I have tried other methods to quit and all have failed. Or, I should say, I failed at them. Anyway, I heard about Chantix, did research on it, talked to my doctor about it and decided to try it. He wrote the script and I took it to my pharmacy. Surprise, surprise...they told me that my insurance flat out denied to cover it.

My question is this: how can quitting smoking NOT be medically necessary? How can an insurance company view it like that? I'm just having a very hard time understanding that. I mentioned to my doctor who stared at me in shock...as if to say "Say WHAT?!?!?!".

I fail to see the logic in that. Opinions, anyone?

EMT

I started the Chantix this morning.

Also, please no lectures about smoking...I've heard them all.

The aero smokeless cigarette is the same as the Nicotrol Inhaler. I tried that...and it didn't work.

I have done my research on Chantix. I wouldn't be taking it if I hadn't.

To Failthful-I see your point but isn't smoking cessation cheaper than cancer treatment? Also, most insurances will pay for drug or alcohol treatment (I did alcohol treatment some 15 years ago and still sober) so why not smoking cessation?

Answer 1

Ugh, go figure... But congrats on you trying to quit. I smoked for 17yrs myself and sparingly thru 3 pregnancies.. I know, bad me.. Even that didn't make me stop. Until nearly 6mos ago during a mega coughing attack my 3yo son said, "moma, u ok? not going to die are you?"
Well, i was in the parking lot of costco and had no intention of quitting just yet. But was just diagnosed w/chronic bronchitis and a broken rib from all the hacking.... I'm only 31.
A friend of mine passed away 2yrs prior and used to cough like I was... I decided then and there.. I was DONE.

I went in and got the patch..also not covered unless pregnant.
I only did step one for a few weeks then stepped down early to step two cos was feeling ill. then quit after a week of that.
It will be 6mos on 11/20...

I never tried that chantix but have a friend and her husband on it and so far so good for them.

I just think it is all a conspiricy man! The insurance companies worke w/the tobacco industry, etc etc...
Anyway, check out Costco's pharmacy and see if they carry it cheaper even w/o your insurance.. Often times they do.

Best of luck to you!

Answer 2

I am a smoker also hoping to quit, and if you haven't (i assume you have) google chantix and check it out very thoroughly as I've heard it works well for some, while others have had very nasty side effects. Another option may be the Aero smokeless cigarette which I also hear works well, with far fewer potential side effects, though you should check it out yourself, and make sure. The aero is a reusable tube into which you put little packets containing small amounts of nicotine and inhale, no fire, no smoke. Quit smoking aids can vary from person to person depending on frequency of use, mental dependency etc. but I definitely hope you can kick the habit!

edit--Forgot to say that the only reason I could see the insurance company turning you down is because smoking, while extremely addictive, is obviously considered personal choice, as opposed to say cancer, and they don't feel they should pay because of your choice. Stupid I know, but it's the only thing I can think of.

As for related cost, I'm not saying I understand a lot of what insurance companies do, just offering an opinion, and as for the Chantix I assumed you had done your research, just wanted to make sure.

Hope it all goes well for you (congrats on the sobriety by the way)

Answer 3

I am quit now too. I haven't had a smoke in about 16 hours. It's hell! I am doing it cold turkey. Today I have been a little testy and have had some anxiety. My understanding is that the actual physical addiction to nicotine last between 3-4 days, depending on how much you smoke. Now the problem is the mental addiction. You're going to have certain things that are going to trigger the desire to smoke, like after dinner, after sex, driving, or if you get angry. I have quit before, and if you think that you are going to just have that "one" cigarette again, forget it. You're most likely going to have to go through this all over again. Change your frame of mind. You're not trying to quit anymore. You are a non-smoker. If someone asks if you would like one, don't say "I quit." Say, "I don't smoke." Little things like this help. Stay strong! One day at a time. If you have a craving, it's only going to be at its worst for 6 minutes. And the longer you go without the easier it will be to never go back. So don't put yourself through this again. Also realize that you are ALLERGIC to them. If you have one it will trigger a response and then it will eventually kill you. I don't know you, but maybe it will help you and me both to know that someone else is doing this too! Good luck!

Answer 4

I used the patch to quit smoking and since that was non-prescription, I didn't get anything from my insurance company. Cost me roughly $50.00 for a 2 week supply and I needed it for 10 weeks. So total cost was $250.

Granted it has paid for itself as I haven't had a cigarette since March 24, 2007.

Answer 5

The truth is, smokers are considered an adverse risk to health proprieters. The fact that you admit to being a smoker for 20 years, probably dosent sit well with Ins. Companies. Think about it, its like a guy with alcohol on his breath coming into a geico office asking for auto insurance. Hes more trouble than he's worth.

Answer 6

well goog 4 u u should quite but it is medically neccesary becuz unless ur emo id want to live 70years+