Medicare coverage is available for smoking cessation treatments. There are limits and rules; discover the details below!
Smoking puts you at risk for heart disease, lung disease, cancer, and a host of other conditions. Stopping smoking is one of the BEST things you can do for your overall health. But it’s easier said than done.
If you speak to your doctor about quitting smoking, Medicare may pay for you to participate in a program that will help you give up cigarettes for good.
Medicare Smoking Cessation
Most people associate cigarette smoking with lung disease. But many don’t realize that smoking causes harm throughout the body.
Smoking is responsible for ten times more premature deaths than all the wars fought by the United States combined. One in five deaths nationwide can be attributed to smoking.
But smoking doesn’t just cause people to die sooner. Smokers are more prone to diseases that lower their quality of life.
It affects bone, tooth, and eye health and can cause type 2 diabetes and rheumatoid arthritis. Quitting smoking reduces these risks in a relatively short amount of time.
Research shows that one-on-one smoking cessation counseling is an effective way to help older adults quit.
Because of this, Medicare added smoking cessation to its list of benefits in the mid-2000s.
Does Medicare Cover Smoking Cessation
Part B‘s medical coverage will pay for smoking cessation counseling provided by a healthcare provider.
Your Medicare coverage may also pay for certain medications that may make it easier for you to quit.
Does Medicare Cover Smoking Cessation Drugs
Medicare will cover certain prescription drugs to help you stop smoking. However, Medicare does not cover over the counter medications or stop-smoking aids like nicotine gum.
Your plan should cover these smoking cessation medications:
- NRT inhaler
- NRT nasal spray
- Bupropion or Zyban
- Varenicline, also known as Chantix
You may be responsible for part of the cost of these medications. The amount you’ll pay will depend on your plan and the amount you spend on prescriptions this year.
Medicare Coverage for Smoking Cessation
Medicare will pay 100% of the cost of counseling to help you quit smoking. This counseling only has coverage if you get it from a doctor or specialist.
You have coverage for up to eight sessions of counseling each year until you can quit for good. To get the full smoking cessation coverage, be sure your provider accepts Medicare assignment.
If you sign up for a smoking cessation plan that you find online or advertised in your community, be sure to ask if Medicare covers it before you commit.
Medicare Advantage Coverage for Quitting Smoking
Medicare Advantage plans have the same smoking cessation benefits as traditional Medicare.
To avoid out of pocket costs, confirm that your doctor accepts Medicare assignment and is in your plan’s network.
Does Medicare Pay for Smoking Cessation
Yes, Medicare Part B will pay for smoking cessation counseling by a healthcare provider.
What are the terms of the coverage that Medicare Part B gives for smoking cessation counseling?
Medicare will pay the full cost of counseling with an in-network doctor. You can have up to eight sessions per year.
What is Smoking Cessation Counseling
Smoking Cessation includes prescriptions, over the counter nicotine replacement products, and quit helplines. Those that participate are more likely to be successful at quitting than those who leave nicotine alone.
What are the Benefits of Smoking Cessation
There are more than 7,000 chemicals in cigarettes, and about 70 of them cause cancer. Quitting cigarettes will significantly reduce your chances of having severe health problems.
When you stop smoking, you reduce your chances of lung cancer, stroke, heart disease, COPD, and emphysema.
In the first 20 minutes of not smoking, your blood pressure decreases. After 12 hours, the carbon monoxide levels return to healthy levels.
Then, in three weeks, circulation and lung functions improve.
The most significant changes start happening after five years when the risk of mouth, throat, esophagus, and bladder cancer reduce by half. Also, the risk of cervical cancer and stroke returns to that of a nonsmoker.
Once you’re a non-smoker for a decade, the risk of death from lung cancer is half that of a current smoker — further, the chances for Pancrease and larynx cancer decreases.
Quit smoking at age 65 and reduce the likelihood you’ll get a disease from smoking by about 50%.
Does Medicare Pay for Chantix
Chantix is a medication designed to help you slowly quit smoking. If you have Part D or a prescription benefit in your Medicare Advantage plan, it should cover Chantix.
Further, out of pocket costs will depend on your plan and how much you have spent on prescriptions this year.
How to Get Smoking Cessation Paid by Medicare
Medicare will pay for smoking cessation counseling if you receive it from your doctor or another healthcare provider. Confirm that the provider accepts Medicare assignment.
If you have a Medicare Advantage plan, also make sure the provider is in your plan’s network.
How Often Does Medicare Pay for Smoking Cessation
Medicare will pay for eight smoking cessation sessions per year. So, if you aren’t able to quit the first time around, you can try again during the next calendar year, and Medicare will pay for it.
How to Bill Medicare for Smoking Cessation
Seeing a doctor that accepts Medicare assignment means the doctor should handle the Medicare paperwork.
If you paid out of pocket and want Medicare to reimburse you, handle the smoking cessation claim the same as any other claim.
What Specialty Can Bill for Smoking Cessation Medicare
Your primary care doctor can provide smoking cessation counseling. The advice can come from another Medicare doctor.
If you’re a smoker, you need good healthcare coverage, including a Medicare Supplement. Tobacco use can affect your premiums, so it pays to shop around.
Medicare FAQ makes the process easier by giving you quotes from top insurance companies in your area.
Get Medigap Coverage to Help with the Costs of Treatment
Did you know that smoking is almost three times more common for people with mental illness? Those with three or more mental health disorders are 61% more likely to smoke.
Medicare coverage for smoking cessation may have coverage of up to 100%; however, mental health care has coverage at 80% after deductibles.
Those with Medicare and mental health issues should consider a Medigap policy. Supplements can cover the Part A deductible and the 20% coinsurance on all services Medicare approves.
Having a supplement could save you thousands of dollars on healthcare costs. If you have ever been a smoker, you know, even after quitting for long periods, the lungs never heal to that of a never smoker.
Did you know that 50% of new lung cancer diagnoses come from FORMER smokers?
Well, with a Medigap plan, you don’t need to stress about possible costly diseases because the coverage protects you from needing to dip into your retirement savings.
These plans require a premium; however, the out of pocket costs are minimal. To get coverage, call us at the number above.
Also, you can fill out an online rate form and have an agent contact you today!