State Agency Directory | Online Services
Change Text Size  FacebookTwitter

Tobacco Cessation Program

Now is the time to start, by way of stopping.
On June 13, 2016, the Legislature of WV voted to adopt a sixty-five cent tobacco tax increase.  Now is the time to stop using tobacco products and start saving money.  PEIA health premiums and optional life insurance premiums give discounts to employees and families that have been tobacco free for at least 6 months.  PEIA also has a program to help you on your way to a healthier life without tobacco.
Tobacco Cessation Program
PEIA PPB Plans A, B & D provide benefits for participants who wish to quit smoking or using smokeless tobacco products.  These include not only cigarettes and cigars. but also smokeless tobacco, e-cigarettes and vaping. 
To access the benefits, simply visit your primary care provider. PEIA will cover an initial and follow-up visit to your physician or nurse practitioner. Tobacco-cessation products, both prescription and non-prescription are available at no cost when prescribed by a physician and purchased at a network pharmacy.  Both the deductible and the copayment are waived.
PEIA will cover two 12-week cycles of drug therapy, even if more than one type of therapy is used. If extended therapy is required, the provider must submit a written appeal to the Director of PEIA with proof of medical necessity.
You can use the benefit (office visits and prescriptions) twice per year (rolling 12 month period). For pregnant participants, PEIA will provide 100% coverage for the tobacco cessation benefit during any pregnancy.
Tobacco cessation products covered under the ACA Preventive Services are: 

• Bupropion HCl tab SR 12 hr 150 mg
• Chantix tab 0.5 mg and 1 mg
• Chantix tab 0.5 mg x 11 tabs and 1 mg x 42 pack
• Nicotine polacrilex gum 2 mg and 4 mg
• Nicotine polacrilex lozenge 2 mg and 4 mg
• Nicotine TD patch 24 hr 21 mg, 14 mg and 7 mg/24 hr
• Nicotrol inhaler system 10 mg
• Nicotrol NS nasal spray 10 mg/mL
Tobacco-Free Savings
Only those members who have been paying the Standard (tobacco-user) premium are eligible for the Tobacco Cessation benefit. If you signed an affidavit claiming to be tobacco-free, you will be declined the Tobacco Cessation benefit.
All health and optional life insurance premiums are based on the tobacco-use status of insureds. Tobacco-free insureds receive the preferred monthly premium rate. Insureds must have been tobacco-free for 6 months prior to the beginning of the Plan Year to qualify for the discount for the entire plan year.  For family health coverage, all enrolled family members must be tobacco-free to qualify the family for the reduced rate. PEIA reserves the right to review medical records to check for tobacco use.
Members who become tobacco-free during a plan year may apply for the discount when they have been tobacco-free for at least six months. PEIA has sixty days from receipt of the tobacco affidavit to process the request and implement the discount. The tobacco-free discount will apply only to future premiums, and WILL NOT be applied retroactively. No refunds will be granted based on tobacco status.
Newly hired insureds must have been tobacco-free for 6 months prior to their effective date of coverage to qualify for the discount, and must complete the tobacco affidavit online or on paper to receive the discount.
Questions about the Tobacco Cessation benefit?  Contact PEIA at 1-888-680-7342.