Does Medicare cover help to quit smoking?

What does Medicare cover to help me quit smoking?

Medicare Part B covers counseling to prevent tobacco use and tobacco-caused disease as a preventive service. The counseling helps you stop smoking or using tobacco, and Medicare covers up to 8 counseling sessions in a 12-month period.

Medicare's national coverage rule covers this counseling for people with Medicare who are outpatients and for those who are in the hospital.

Who qualifies for Medicare's quit-smoking counseling?

Under CMS's national coverage rule, Medicare covers tobacco cessation counseling for people with Medicare who meet all of these conditions:

• You use tobacco, regardless of whether you have signs or symptoms of tobacco-related disease.
• You're competent and alert at the time the counseling is provided.
• Your counseling is furnished by a qualified physician or other Medicare-recognized practitioner.

How do the 8 counseling sessions work?

CMS allows 2 individual tobacco cessation counseling attempts in a 12-month period. Each attempt may include up to 4 intermediate or intensive sessions, for a total of up to 8 sessions in 12 months. You and your practitioner can choose between intermediate sessions (more than 3 minutes but less than 10 minutes) and intensive sessions (more than 10 minutes) for each attempt.

What do I pay for quit-smoking counseling?

You pay nothing for the counseling sessions if your doctor or other health care provider accepts assignment. CMS's coverage rule notes that the Affordable Care Act waived the Medicare coinsurance and Part B deductible for this service starting January 1, 2011.

Does Medicare cover quit-smoking medicine?

Medicare drug coverage (Part D) may cover prescription quit-smoking drugs. CMS's Medicare Prescription Drug Benefit Manual lists prescription-only smoking cessation products among the drugs not excluded from Part D coverage, and it lists over-the-counter smoking cessation drugs as not covered under the basic Part D benefit.

Each Medicare drug plan has its own list of covered drugs, called a formulary, so check your plan's formulary for a specific drug. See how Medicare covers prescription drugs.

What else does Medicare offer people who smoke?

Other Part B preventive benefits can help:

• At the one-time "Welcome to Medicare" preventive visit, your provider reviews your potential risk factors for substance use disorder (like alcohol and tobacco use) and refers you for treatment, if needed.
• Medicare covers a yearly lung cancer screening with low-dose computed tomography if you're between 50 and 77, have no signs or symptoms of lung cancer, are a current smoker or quit within the last 15 years, have a tobacco smoking history of at least 20 "pack years" and get an order from your doctor or other health care provider; before your first screening, you need an appointment with your provider to discuss the benefits and risks. See Medicare's lung cancer screening rules.