Tobacco cessation

Tobacco cessation is now an insured service.

Alberta Health has confirmed that reliance on tobacco products is considered an addiction and as such addiction counseling may be claimed to the Alberta Health Care Insurance Plan under the appropriate billing codes.

In addition, the Alberta Quits program is in effect and visits for patients requesting a prescription for the insured drug Champix are also payable under the Alberta Health Care Insurance Plan.

Coverage for Champix

Effective June 15, members of Alberta government-sponsored supplementary health plans are eligible to receive coverage for Champix^® (Varenicline Tartrate).

This coverage is a restricted benefit. Eligible plan members are:

1. 18 years of age and older.
2. On a government-sponsored supplementary health plan.
3. Enrolled in an Alberta Health Services (AHS) tobacco-cessation program (AlbertaQuits Helpline and/or AlbertaQuits Groups).

Any member of the Alberta government-sponsored supplementary health plans who wishes to quit tobacco using Champix^® must show proof of enrolment in an AHS tobacco-cessation program in order to fill a prescription.

The individual must follow these steps in order to get the prescription initially and to receive subsequent refills:

1. The individual will visit his/her physician to receive a prescription for Champix^®.
2. In addition to providing the patient with a prescription, the physician will refer the patient to an Alberta Health Services tobacco-cessation program.
3. The patient will enrol in an AHS tobacco-cessation program.
4. The patient will request an intervention form from the tobacco-cessation program.The patient will present the form to a pharmacist and receive up to a four-week supply of Champix^® medication. (Initially a single starter pack is allowed).
5. Prior to each prescription fill, renewed on a four-week basis, the patient must request a letter of confirmation of continued enrolment from the tobacco-cessation program.
6. The patient will provide his/her pharmacist with the prescription and the letter of enrolment when having the drug refilled and will repeat steps 5 and 6 for continued tobacco-cessation therapy.

Three forms have been created to assist health care professionals and patients:

1. Health care Professional Information for Prescribing Champix^® (varenicline tartrate) for Subscribers of Government-Sponsored Supplementary Health Plans.
   Form 1 is intended to be used by physicians and provides detailed information on who is eligible for this initiative, what tobacco-cessation programs can be utilized and the steps that should be followed by patients.
2. Patient Information - Receiving Champix^® under your Government-sponsored Supplementary Health Plan.
   Form 2 is meant to be distributed to patients to assist them in following the proper steps to receive their medication.
3. Champix^® Intervention Proof-of-Enrolment Form.
   Form 3 will be distributed by AHS tobacco-cessation programs to patients as proof of enrolment.

More information available at:
Prescribing Champix (varenicline tartrate) for Subscribers to Government-Sponsored Supplementary Health Plans >>