In 2021, Pfizer recalled Chantix due to concerns about potential cancer-causing compounds called nitrosamines. But Medicare Part D plans should cover the generic varenicline.

Medicare prescription drug plans cover several prescription drugs designed to help you quit smoking. One of them is varenicline (formerly sold under the brand Chantix). This is a medication that lessens the effects of and reduces cravings for smoking.

Keep reading to find out more about Medicare’s coverage of this Medicine and how Medicare covers other methods to help you quit smoking.

Medicare requires Medicare Part D plans to cover certain medications designed to help people quit smoking. varenicline is one of those medications.

Medicare Part D plans each have a formulary, which lists the plan’s covered medications. These drugs are usually further divided into tiers. Tier 1 medications are usually generic, while tier 5 contains specialty drugs.

Knowing which tier a medication falls under can provide an indication of how much you might pay in coinsurance for your prescription.

Medicare prescription drug plans typically classify varenicline as a tier 3 or 4 medication. That said, Part D plans vary based on your geographical area, and you’ll need to look at your specific plan’s formulary to find the tier and the associated cost.

What about Part C (Medicare Advantage) coverage?

Medicare Part C is a plan where a Medicare beneficiary selects a private insurer to provide their Medicare Part A and Part B benefits. Many policies also offer Medicare Part D benefits as well.

Medicare requires Medicare Advantage plans to offer the same coverage level as Original Medicare and stand-alone Part D plans. If you have Part D coverage through Medicare Advantage, your plan should cover varenicline.

Can a Medigap plan help with my costs?

Medigap is a term for Medicare supplement plans that some people with original Medicare purchase to help reduce their out-of-pocket costs.

Although some older Medigap plans cover prescription drug costs, more recent plans (those sold since 2006) aren’t allowed to.

When you have Medicare, your costs for varenicline may depend on how you pay for your medications and what coverage stage you are in.

Current pharmacy prices range widely from $30 to $128 for 30 tablets. Your actual out-of-pocket costs will vary depending on your plan, the pharmacy you use, and the amount in your supply.

While you’re likely to have to pay something for the drug, the following programs may help you save money:

  • Medicaid: Medicaid is a state-run assistance program that can help you pay for medications if you have trouble affording them. Some people qualify for both Medicaid and Medicare. Click here to learn more about Medicaid’s state prescription drug resources.
  • Medicare Extra Help program: The Medicare Extra Help program provides prescription drug cost assistance for those who meet income qualifications. These criteria change annually, so check your status each year.
  • Medicare savings programs: A Medicare savings program helps you pay for healthcare costs including prescription drugs. If you qualify for a savings program, you also automatically qualify for Extra Help.
  • Local community assistance programs: Several community organizations, including extensions of nonprofit chapters like the American Heart Association and the Program of All-Inclusive Care for the Elderly (PACE) may provide assistance with medications.
  • Manufacturer coupons: Many prescription drug manufacturers offer discount coupons that you can either mail in after you use the coupon or submit directly to your pharmacy to save money on your medications.
  • Prescription drug discount websites: Several websites offer prescription drug discount cards or other information on medicine cost-savings. Examples include AmericasPharmacy, Choice Drug Card, GoodRx, and ScriptSave WellRx.

While this may not apply to varenicline, you can also ask your doctor about generic options or if there are less-expensive options to help pay for your other medications.

Other medications that Medicare Part D should cover include:

  • Zyban (bupropion)
  • nicotine replacement therapy inhalers
  • nicotine replacement therapy sprays

In addition, Medicare Part B covers smoking cessation services, which means this is also covered by Medicare Advantage (Part C).

It includes counseling and other methods to help you quit for up to two attempts each year, with a total of eight sessions. Counseling is available through phone or group sessions.

Doctors prescribe varenicline to help a person quit smoking, but it isn’t a nicotine replacement therapy. Unlike nicotine patches, gums, or sprays, varenicline doesn’t contain nicotine.

Instead, it works by attaching to receptors in your body that are stimulated when you smoke. These receptors are what give you that “feel-good” sensation when smoking. When the nicotine wears off, you start to crave another cigarette.

Varenicline “blocks” nicotine from attaching to the receptors. It keeps it from giving you the same high and crash, which ideally will help you to quit more effectively.

Varenicline has some side effects. These may include:

  • constipation
  • gas
  • nausea
  • vomiting
  • problems sleeping
  • unusual dreams

You should also talk with your doctor about any medicines and supplements you take to make sure they won’t interact with varenicline.

Some people may use varenicline and nicotine replacement therapies together, but this may result in greater symptoms of abdominal upset.

Medicare prescription drug plans will cover varenicline to help you quit smoking. The covered costs will depend on your prescription drug plan, so contact your plan and ask for a cost estimate.

Your plan may also require you to use an approved pharmacy.

If you’ve tried to quit before but need more help, trying varenicline along with Medicare-approved smoking cessation counseling may work for you.