Does Medicare cover Chantix?
Your Chantix prescription is covered by Medicare Part D and Medicare Advantage (Part C). Chantix is covered by most health insurance companies, too. Medicare or health insurance can lower your Chantix copay to $1. However, insufficient health coverage will put your Chantix costs at $485. A few rounds of full-priced Chantix could hurt more than the side effects. Compare companies and shop around to find reliable coverage for Chantix.
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Michael Vereecke
Commercial Lines Coverage Specialist
Michael Vereecke is the president of Customers First Insurance Group. He has been a licensed insurance agent for over 13 years. He also carries a Commercial Lines Coverage Specialist (CLCS) Designation, providing him the expertise to spot holes in businesses’ coverage. Since 2009, he has worked with many different insurance providers, which gives him unique insight into the insurance market...
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UPDATED: Jul 6, 2023
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UPDATED: Jul 6, 2023
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Medicare Part D and Medicare Advantage covers the majority of Chantix cost.
- Individuals prescribed Chantix will receive 53 pills at the start.
- Without Medicare Part D and Medicare Advantage, you could pay nearly $500 for Chantix.
- Chantix is the brand name of the drug Varenicline.
If you’re a Medicare recipient that wants to quit smoking and break the nicotine addiction, you’ll come across this question: Does Medicare cover Chantix? Under certain Medicare insurance plan parts, eligible patients can pay as low as $1 for Chantix.
Your health insurance would cover Chantix, too. Read through this brief guide to learn more about how Medicare covers Chantix and how much Chantix costs.
If you don’t have health insurance or Medicare insurance to cover Chantix, enter your ZIP code in the free comparison tool above to compare health companies in your area.
Table of Contents
Does Medicare cover Chantix?
Yes. Medicare covers Chantix under Medicare Part D and Medicare Advantage (Medicare Part C). Also, the Medicaid health plan can cover Chantix. Be sure to ask your state Medicaid program about prescriptions like Chantix. Also check with your healthcare professional about the benefits vs any adverse effects. Most health insurance companies can provide reduced costs for Chantix since most insurance plans include prescription medications to some degree.
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What tier is Chantix on?
Chantix is a tier-three drug because its cost is the third highest on the four-tier formulary.
According to the HealthCare Marketplace, a formulary (drug list) is a list of prescription drugs covered by your health insurance provider’s prescription drug plan.
Tier-three prescription drugs are more expensive than tier-two and tier-one drugs.
How much is Chantix?
Without healthcare coverage or the proper Medicare coverage, Chantix is $485 for 53 tablets. This cost rivals most health insurance premiums, so it would be in your best interest to find coverage to help out with Chantix cost.
How much does Chantix’s copay cost with Medicare?
If you have the proper coverage through Medicare or sufficient health insurance, your copay for Chantix is $8 to $9. Once you’ve met your deductible, your copay can be as low as $1.
What Are Five Ways You Can Save on Chantix Prescriptions?
If your Medicare program or health insurance policy doesn’t give you affordable Chantix costs, here are five ways you can save on the smoking cessation aid drug.
- Get Medicaid – If you qualify for Medicaid, you can get the cost of Chantix reduced.
- Prescription Discount on the Web – The internet is a great resource to find coupons for Chantix. Search cyberspace for drug discount websites to reduce cost.
- Chantix Coupons – Believe it or not, Chantix has coupons to use at pharmacies across the country to bring down the cost of the medicine.
- Use Medicare’s Extra Help and Savings Programs – Medicare has a program that will give you assistance for drug costs.
- Local Community Programs – There are state-level programs that can assist you with prescription costs. Ask your healthcare provider for more details.
If you have to pay full price, weigh the health benefits and any symptoms during treatment against the cost by discussing it with your physician.
Did we miss something? Continue searching for ways to save on the cost of prescription Chantix so that you can avoid the $485 price tag.
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How does Chantix work for you?
According to MedlinePlus, Chantix is a brand name that provides Varenicline. It works by blocking nicotine’s pleasurable effects. Chantix is a smoking cessation aid.
Smoking cessation means you’re in the process of kicking the smoking habit. Chantix helps with that process. However, Chantix isn’t without both common side effects and some uncommon ones. Let’s look at the side effects below.
Chantix (Varenicline) Side Effects
Minor Side Effects (Contact a Doctor if These Symptoms Don't Go Away) | Major Side Effects (Stop Taking Varenicline and Get Medical Help Immediately) |
---|---|
nausea | swelling (of the face, throat, tongue, lips, gums, eyes, neck, hands, arms, feet, ankles, or lower legs) |
constipation | hoarseness |
diarrhea | difficulty swallowing or breathing |
gas | rash |
abdominal pain | swollen, red, peeling, or blistering skin |
vomiting | blisters in the mouth |
heartburn | pain, squeezing, or pressure in the chest |
bad taste in the mouth | pain or discomfort (in one or both arms, back, neck, jaw, or stomach) |
dry mouth | shortness of breath |
increased or decreased appetite | sweating |
toothache | nausea, vomiting, or lightheadedness with chest pain |
trouble falling asleep or staying asleep | slow or difficult speech |
unusual dreams or nightmares | sudden weakness or numbness (of an arm or leg, especially on one side of the body) |
headache | calf pain while walking |
lack of energy | seizures |
back, joint, or muscle pain | sleepwalking |
abnormal menstrual cycles |
Chantix has many side effects, which is why it’s essential to contact your healthcare provider. However, it should stop you from getting preventative care to fight the urge to smoke tobacco.
Does Medicare Cover Chantix? What’s the Bottom Line?
Chantix is covered by health insurance, Medicare Part D, Medicare Advantage, and Medicaid. Without reliable coverage, you could be paying almost $500 for Chantix. The best insurance companies can get you the help you need.
If your Medicare policy doesn’t cover Chantix, use our free comparison tool to find a health insurance company that will provide help with Chantix cost.
Case Studies: Medicare Coverage for Chantix
Case Study 1: John’s Medicare Coverage
John, a Medicare recipient, is determined to quit smoking and seeks coverage for Chantix. He discovers that his Medicare Part D plan includes coverage for Chantix, allowing him to pay as low as $1 for the prescription. With the support of his insurance, John can now pursue his goal of quitting smoking.
Case Study 2: Sarah’s Health Insurance Coverage
Sarah, who has health insurance through her employer, is also interested in using Chantix to quit smoking. She learns that her health insurance company covers Chantix, which means she can benefit from reduced costs for the prescription. Sarah decides to explore different health insurance companies to ensure she finds reliable coverage that suits her needs.
Case Study 3: Mark’s Uninsured Situation
Mark, unfortunately, doesn’t have health insurance or Medicare coverage to help with the cost of Chantix. Without coverage, Mark would have to pay $485 for 53 tablets, a significant expense. Mark is advised to explore options such as Medicaid or compare health companies in his area using the free quote tool to find affordable coverage for Chantix.
Case Study 4: Emily’s Medicare Advantage Plan
Emily, a Medicare Advantage plan beneficiary, is pleased to discover that her plan covers Chantix. With a copay as low as $1, Emily can access the smoking cessation aid and begin her journey towards quitting smoking. The coverage provided by her Medicare Advantage plan ensures that the cost of Chantix is manageable for her.
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Frequently Asked Questions
Does Medicare cover Chantix?
Yes, Medicare may cover Chantix under certain circumstances, providing beneficiaries with potential access to this medication for smoking cessation. Chantix, also known by its generic name varenicline, is a prescription medication that helps individuals quit smoking by reducing cravings and withdrawal symptoms.
What parts of Medicare cover Chantix?
Chantix may be covered by Medicare Part D prescription drug plans or Medicare Advantage plans that include prescription drug coverage.
Is there a deductible or copayment associated with Medicare coverage for Chantix?
Yes, there may be a deductible, copayment, or coinsurance associated with Medicare coverage for Chantix, depending on your specific Medicare plan.
Can I get Chantix through Medicare if I have Original Medicare (Part A and Part B) only?
Original Medicare (Part A and Part B) does not typically cover prescription medications like Chantix. However, you may have the option to enroll in a standalone Medicare Part D plan to get coverage for Chantix.
Are there any alternative options for smoking cessation covered by Medicare?
Yes, Medicare covers other smoking cessation options, such as nicotine replacement therapy (patches, gum, lozenges) and certain prescription medications besides Chantix.
Will Medicare cover Chantix for off-label uses?
Medicare generally covers medications for uses approved by the U.S. Food and Drug Administration (FDA). Coverage for off-label uses of Chantix may vary depending on the specific circumstances and the Medicare plan.
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Michael Vereecke
Commercial Lines Coverage Specialist
Michael Vereecke is the president of Customers First Insurance Group. He has been a licensed insurance agent for over 13 years. He also carries a Commercial Lines Coverage Specialist (CLCS) Designation, providing him the expertise to spot holes in businesses’ coverage. Since 2009, he has worked with many different insurance providers, which gives him unique insight into the insurance market...
Commercial Lines Coverage Specialist
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.