Having worked for several companies and been a part of several health plans, I’ve found out that one thing that may be conspicuously excluded from health coverage is rehab from nicotine/tobacco products. Rehab from illegal drugs and illnesses CAUSED by tobacco use are apparently covered. Why would they say no to smoking cessation therapy?
I can think of the following possibilities:
The insurance companies have determined that smoking cessation programs aren’t worth the effort considering the cost of the programs and the relapse rate, and would prefer to just pay for the lung cancer treatment if it happens. (though a solution could be to only fund up to a certain number of retries, e.g. if you’ve relapsed 3 times after having the insurance company pay for a quit smoking program three separate times, you are deemed a hopeless case and are on your own)
That’s just the way it’s done, perhaps because the original plan documents were written 50 years ago when quitting smoking was primarily considered to be a matter of willpower.
Smoking cessation programs don’t operate on the same networks as most healthcare providers and aren’t set up to bill insurance.
Big Tobacco $$$$$ paid to the health insurance companies.
Nicotine addiction still isn’t considered to be a “real” medical condition, unlike addiction to meth or heroin.
If something isn’t being done by the insurance industry, the answer is, “it’s not cost effective.” If it was someone would’ve come up with a policy by now.
Insurance is there to make money, it’s not a non-profit industry.
Unless you take in more than you make it’ll lose money and no one will underwrite the idea.
Me either. I know that the insurance where I work now covers it; a coworker successfully used Chantrix to quit. I think they also have quit smoking hotlines and other programs. I don’t smoke, so I haven’t paid close attention to what exactly is available, but it’s something.
Here in Minnesota, state law requires that insurance policies cover things like alcohol/drug addiction treatment. That may be true in other states, too.
And Minnesota insurance companies (especially Blue Cross/Blue Shield) do spend a lot of money on anti-smoking efforts. So presumably they do find that cost-effective. You can pay for a lot of anti-smoking efforts for the cost of treating one patient with cancer!
Is it really that expensive? I thought nicotine patches were OTC. Which would make it also awkward to pay with insurance right? Does anyone actually go to smoking REHAB? Seems like overkill. Some OTC patches and the free 12 step at the local church are in order.
OTOH I have had health plans which help you out with your gym membership, but it’s a major PITA.