MedicaidCoverageLow impact
Tobacco Cessation Products and Services Covered Under the BadgerCare Plus Core Plan for Childless Adults
Wisconsin Medicaid (ForwardHealth)·WI · Family Medicine, Internal Medicine, General Practice·Medical Policy
Effective date
Jan 1, 2009
We identified it
Jun 20, 2026
Summary
Wisconsin's BadgerCare Plus Core Plan for Childless Adults will cover tobacco cessation products and services starting January 1, 2009, including generic drugs and OTC nicotine products with copayments of $0.50-$3.00. Written prescriptions are required for all tobacco cessation products with diagnosis code 305.1, and prior authorization is needed for uses outside approved diagnoses.
Action Required
By January 1, 2009: Wisconsin providers must verify BadgerCare Plus Core Plan enrollment before providing tobacco cessation services. Update billing system to require written prescriptions for all tobacco cessation products with diagnosis code 305.1. Obtain separate prior authorizations for Core Plan vs Standard/Benchmark Plans. Apply copayments of $0.50-$3.00 for covered services.