Resources

Breaking Free: The LifeMatters Tobacco Cessation Program

The LifeMatters Program is pleased to provide Breaking Free, a tobacco cessation program. This telephone counseling model is based on a study conducted by the University of California, San Diego. This study showed that combining multiple telephone sessions with a coach and the use of a workbook produced significantly higher success rates than a single session.

Our workbook entitled 'Breaking Free: A Guide to Becoming Tobacco Free' will be sent to you once you have signed up for the program. At the time of sign up, a pre-quit session will be scheduled at your convenience.

The pre-quit session is designed to review your smoking and quitting history, motivation for quitting at this time, strategies for coping including nicotine replacement options, as well as to set a quit date. This session is likely to last up to 60 minutes.

During the quit date session, you and your coach will review motivations for quitting, coping strategies and relaxation techniques described in the self-help manual. This session may last up to 20 minutes.

The remaining four follow-up sessions are designed to provide support, relapse prevention strategies and to explore your new image as a non-smoker. While it is recommended that these sessions be held on the third, seventh, fourteenth and thirtieth days following your quit date, they will be scheduled at your convenience. You are also invited to contact your coach at any time in between sessions for support and guidance.

Congratulations on taking the initial step to find out more about the program. We hope you'll take the next step to becoming tobacco-free. To begin the process, simply contact the LifeMatters Program and ask to speak to a Breaking Free Coach.

LifeMatters

800-367-7474

Insurance Provider Resources

Anthem Select & Traditional HMO’s

(855) 839-4524

Members who participate in a smoking cessation class/program will be reimbursed up to $100 per class/program per calendar year for nicotine dependency. Smoking cessation drugs that may be purchased over-the-counter without a prescription are not covered. We cover medically necessary drugs for nicotine dependency that require a prescription. This does not include those services required under the “Preventive Care Services” benefit.

Prescription drugs to help you stop smoking or reduce your dependence on tobacco products, as well as over-the-counter nicotine replacement products (limited to nicotine patches and gum) are covered when obtained with a doctor’s prescription. These drugs and products will be covered as preventive care services.

Blue Shield Access+ HMO

(800) 334-5847

Over-the-counter and prescription smoking cessation drugs are covered for Members when ordered by a Physician. See Section Y for more information about smoking cessation.

Members who participate and complete a smoking cessation class or program will be reimbursed up to $100 per class or program per calendar year. Members may contact their medical group or IPA (Independent Practice Association) for information about these classes and programs. If you have a question about the smoking cessation benefit, you should call Blue Shield Member Services at 1-800-334-5847.

Health Net SmartCare & Salud Y Mas HMO’s

(888) 925-4921

Quit For Life^® Tobacco Cessation

Our refreshed tobacco cessation program comes online with coverage for any type of tobacco use and significant enhancements to our previous online smoking cessation program. The program begins with an in-depth assessment and the development of a personalized cessation plan, including medication support recommendations for over-the-counter and prescription drugs. For encouragement and support throughout, participants can access up to four proactive, one-on-one counseling calls, plus unlimited calls to Nurse Advice Line.

All CalPERS Health Net Basic members who complete the Quit For Life tobacco cessation program by enrolling and completing four live calls with their quit coach can earn a $100 incentive per calendar year.

Kaiser HMO

(800) 464-4000

Individual counseling during an office visit related to smoking cessation:  No charge

• Tools
• Classes
• Pharmacy – medications with a prescription from your doctor or through Wellness Coaching by Phone or quit smoking health class.

Guides to download

Tips on how to cope with cravings

PERS Care, Choice & Select PPO’s

(877) 737-7776

Smoking Cessation Program

This Plan covers without cost-sharing: screening for tobacco use; and, for those who use tobacco products, at least two tobacco cessation attempts per year.

A smoking cessation attempt includes coverage for: four tobacco cessation counseling sessions of at least 10 minutes each (including telephone counseling, group counseling and individual counseling) without prior authorization; and all Food and Drug Administration (FDA)-approved tobacco cessation Medications (including both Prescription and over-the-counter Medications) for a 90-day treatment regimen when prescribed by a Provider without prior authorization.

In addition to the smoking cessation attempts described in the preceding paragraph, the Plan will reimburse a Member up to a maximum of $100 per Calendar Year for behavior modifying smoking cessation counseling or classes or alternative treatments, such as acupuncture or biofeedback, for the treatment of nicotine dependency or tobacco use when not covered under benefits stated elsewhere in this Evidence of Coverage. A legible copy of dated receipts for expenses must be submitted along with a claim form to Anthem Blue Cross to obtain reimbursement.

Costs associated with smoking cessation programs not covered under the Plan without cost sharing do not apply toward the Maximum Calendar Year Medical Financial Responsibility limits.

PORAC PPO

(800) 937-6722

Smoking Cessation Programs

No Co-Pay except any amount in excess of the Maximum Allowed Amount.

Not subject to the Calendar Year Deductible and applies toward the Out-of-Pocket Expense Amount.

Benefits are provided for covered charges incurred for approved behavior modifying smoking cessation programs. Behavior modification does not consist of hypnosis, shock therapy, acupressure, acupuncture or other similar methods to alter behavior. Benefits are provided when verification of completion of one of the following approved programs is submitted to Anthem Blue Cross:

Class Supported Programs

1. American Lung Association - 'Freedom From Smoking'. Call 1-800-586-4872 or the local lung association office or visit their website for information.

2. Medical clinic or Hospital-based programs. Consult the Member’s Physician or local community Hospital for information.

Self-Help Program: The Smokenders program is a 7-week audio cassette self-help program that is available only to Members who live beyond 25 miles from approved class-supported program locations or who work shifts that are not compatible with class-supported programs. Anthem Blue Cross has negotiated a significant discount for Smokenders kits, which must be obtained by requesting a special coupon. To determine the Member’s eligibility for the Smokenders program and to obtain a Smokenders coupon, call the PORAC - Anthem Blue Cross customer service unit.

COVERED SERVICES AND SUPPLIES

2017 PORAC Prudent Buyer Classic Plan (Basic) Page 45

Note: Smokenders programs purchased from any other source will not be reimbursed.

Benefits will be provided subject to the following:

1. The Member must enroll in an approved Smoking Cessation Program and retain the payment receipt.

2. The Member must request a Health Promotion Program Reimbursement Form and a Certificate of Completion from the PORAC - Anthem Blue Cross customer service unit.

3. The Member must obtain the instructor's signature on the Certificate of Completion, verifying that he or she has completed the program, attended every session and that the Member is smoke free at the time of the program's completion.

4. The Member must mail a copy of the signed Certificate of Completion and Reimbursement Form with the receipt to Anthem Blue Cross for reimbursement.

Sharp Performance+ HMO

(855) 995-5004

Smoking Cessation

Members who participate and complete a smoking cessation class or program will be reimbursed up to $100 per class or program per calendar year. For more information about these classes and programs, please contact Customer Care.

Customer Care: Toll-free at 1-855-995-5004 7:00 a.m. to 8:00 p.m., 7 days a week

United Health Care HMO

(877) 359-3714

Smoking Cessation

Members who participate and complete a smoking cessation class or program will be reimbursed up to $100 per class or program per calendar year. Members may contact their medical group for information about these classes and programs. If you have a question about the smoking cessation benefit, you should call UnitedHealthcare at 1- 877-359-3714 or 711 (TTY)

The Member’s Participating Medical Group may offer additional community health programs. These programs are independent of health improvement programs offered by UnitedHealthcare and are not covered. Fees charged will not apply to the Member’s Copayment maximum.