These data reflect the most commonly purchased benefits package for each of the health plans in
the year 2000. Coventry/Principal would not supply updated information.

HMO Smoking Cessation
Aetna US Healthcare Not listed in Evidence of Coverage.
Blue Cross Blue Shield Covers: Smoking cessation medications.

Limits: Limited to one course of prescription drug treatment per calendar year or two courses of prescription drug treatment per lifetime.

CIGNA / Healthsource Excluded
Doctors Health Plan Excludes: Any service or supply to eliminate or reduce nicotine addiction, including: nicotine withdrawal programs, patches and gum.
Generations Excludes: Treatment for nicotine dependency or smoking cessation is not covered.
Optimum Choice Excluded.
PARTNERS Excluded, except when purchased separately through a supplemental rider.
Coventry/Principal Health Care of the Carolinas Excluded.
QualChoice Covers: Zyban, Nicotine replacement therapy, ALA Group Clinic, and QualChoice approved self-help materials.

Limits: One course of Zyban is covered per calendar year if the member has prescription drug rider. Qual Choice will cover the costs of attending one ALA Group Clinic per year (with a maximum allowance). Member must submit certificate of completion to Qual Choice to be reimbursed for the program costs. To be reimbursed for the self-help materials, the member must submit a receipt to Qual Choice.

Cost Sharing: Copayments may apply. Nicotine replacement therapy is covered at 50% if the member is enrolled in an approved smoking cessation class.

The Wellness Plan of North Carolina, Inc. Excludes: Behavior modification programs and hypnotic therapy for smoking cessation. Also excludes prescription and non-prescription drugs for the purposes of smoking cessation.
United HealthCare Excludes: Services and supplies for smoking cessation programs and treatment of nicotine addiction.
WellPath Covers: Over-the-counter and prescription treatments of smoking cessation up to $165 per lifetime.

Supplemental Rider covers: reimbursement up to $165 per lifetime for over-the-counter and prescription treatments of smoking cessation. Most groups purchase the supplemental rider.

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