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Medicare Coverage for Smoking Cessation Treatments


Medicare coverage is available for smoking cessation treatments. 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 smoking for good.

Medicare Coverage for Smoking Cessation

Most people associate cigarette smoking with lung disease. But many don’t realize that smoking causes harm throughout the entire body in many different ways. Smoking doesn’t just cause people to die sooner. Smokers are more prone to diseases that lower their quality of life.

For example, smoking can cause strokes and lung diseases like COPD and emphysema. It can cause cancer in almost any part of the body. 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.

What’s 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.

Does Medicare Cover Smoking Cessation Prescriptions?

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. To get prescription coverage, you must have a Part D prescription drug plan or a Medicare Advantage plan that includes prescriptions.

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.

How Much Will Medicare Cover 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.

Does Medicare Advantage Cover Smoking Cessation?

Medicare Advantage plans have the same smoking cessation benefits as Medicare. To avoid out of pocket costs, confirm that your doctor is in your plan’s network.

Does Medicare Cover 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. The out of pocket costs will depend on your plan and how much you have spent on prescriptions this year.

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 Get Medicare Coverage for Smoking Cessation

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.

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, unlike Medicare Advantage plans where you pay more as you go.

We can compare all your supplemental Medicare options including Medigap, Medicare Advantage, and Part D. Give us a call today, or fill out an online rate form and see all the Medicare options available now in your area.

Lindsay Engle

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

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