As of July 2017, North Carolina changed quitline eligibility limiting services for insured callers to one coaching call and no NRT. Uninsured, Medicaid and Medicare callers are eligible to receive 4 coaching calls and NRT. Uninsured callers can receive up to 8 weeks of combination NRT therapy (i.e., nicotine patches and nicotine gum or lozenges); Medicaid and Medicare callers receive a 2-week starter kit of combination NRT therapy; and Medicaid callers can receive a standing order for an additional 12 weeks of combination NRT therapy fillable at a pharmacy. These case studies of North Carolina, South Carolina, and Utah showcase each state’s eligibility criteria, rationale, key considerations for making changes to criteria, how changes were implemented, challenges, and successes.