MedicaidCoverageMedium impact
Tobacco Cessation Products and Services Covered Under BadgerCare Plus and Wisconsin Medicaid
Wisconsin Medicaid (ForwardHealth)·WI · Family Medicine, General Practice, Internal Medicine +1 more·Medical Policy
Effective date
Feb 1, 2008
We identified it
Jun 20, 2026
Summary
BadgerCare Plus (Wisconsin Medicaid) now covers over-the-counter tobacco cessation products (nicotine gum and patches) starting February 1, 2008. A written prescription from a prescriber is required for all tobacco cessation products, and diagnosis code 305.1 must be indicated on prescriptions.
Action Required
By February 1, 2008: Billing team must update procedures to accept prescriptions for OTC tobacco cessation products (nicotine gum and patches) for BadgerCare Plus and Wisconsin Medicaid members. Ensure prescribers include diagnosis code 305.1 on all tobacco cessation prescriptions. Update copayment collection procedures - Standard Plan members pay existing Medicaid copayments, Benchmark Plan members pay up to $5.00 per prescription. Note that SeniorCare does NOT cover OTC tobacco cessation products.