Medicare Coverage for Quitting Smoking: Perks and Details
In the journey towards quitting smoking, many challenges can arise, including difficulty sleeping, irritability, anxiety, restlessness, and difficulty concentrating. However, help is available for Medicare beneficiaries looking to kick the habit.
Under the Affordable Care Act, Medicare now provides coverage for smoking cessation services, offering a range of support to help individuals on their path to quitting.
## Available Services
Medicare covers tobacco use screenings for all adults and adolescents. For those who use tobacco products, tobacco cessation counseling is also covered, with expanded counseling available for pregnant women. Services can be delivered by a physician, group counseling, or telephone counseling. Additionally, prescription medications and nicotine replacement therapy, such as gum or lozenges, may be covered under Medicare Part D.
## Coverage Details
All Medicare beneficiaries who use tobacco products are eligible for these services, regardless of symptoms or disease. Services must be provided by qualified healthcare professionals such as physicians, nurse practitioners, physician assistants, or clinical nurse specialists. Tobacco cessation counseling can also be provided via telehealth, expanding accessibility.
## Out-of-Pocket Costs
For services like counseling, Medicare Part B typically covers 80% of the approved costs after deductibles are met. The remaining 20% is usually covered by the beneficiary unless they have supplemental insurance. Prescription smoking cessation medications are covered under Medicare Part D, which often requires a copayment or coinsurance depending on the specific plan.
## Additional Support
The National Cancer Institute Quitline, American Cancer Society Quitline, American Lung Association Freedom From Smoking, and state programs can provide advice on stopping smoking. SmokeFree.gov offers social media platforms where people can connect with others for support during the quitting process. Employers, private insurance companies, local hospitals, and the local health department often offer free programs to help people quit smoking.
In conclusion, while Medicare covers many aspects of smoking cessation, beneficiaries may still face some out-of-pocket costs, especially for medications and services not fully covered by Part B or Part D. A plan can be helpful when quitting smoking, as only 4% to 7% of people who try to quit without a plan are successful. Medicare helps pay for smoking cessation counseling and some medication, making the journey towards a smoke-free life more accessible for many Americans.
[1] Source: medicare.gov [2] Source: cancer.gov [3] Source: health.gov [4] Source: cdc.gov
- The National Cancer Institute Quitline, American Cancer Society Quitline, American Lung Association Freedom From Smoking, and state programs, in addition to SmokeFree.go's social media platforms, provide useful advice for Medicare beneficiaries aiming to quit smoking.
- Smoking cessation services, including tobacco use screenings, tobacco cessation counseling, and prescription medications or nicotine replacement therapy, are covered under Medicare for those who use tobacco products.
- Medicare beneficiaries can receive expanded tobacco cessation counseling, regardless of symptoms or disease, from qualified healthcare professionals such as physicians, nurse practitioners, physician assistants, clinical nurse specialists, and via telehealth.
- While Medicare Part B and Part D offer coverage for many smoking cessation services, some out-of-pocket costs may still apply, particularly for prescription medications and services not fully covered.