Medicare coverage to help you quit smoking
Section IV.m. Preventive Care Services
Question 20 of 26 (use "Last" or "Next" buttons to see more)
Medicare covers counseling to help you quit smoking (smoking cessation).
Medicare will cover two counseling attempts at quitting smoking per year. Each attempt includes four sessions. Medicare will cover a total of eight sessions every 12 months. Your cost-sharing depends on whether or not you have been diagnosed with an illness that is caused or complicated by smoking.
If you have Original Medicare, you no longer pay coinsurances or deductibles for smoking cessation counseling if you have not been diagnosed with an illness that is caused or complicated by smoking and you see a Medicare-recognized doctor or other health care provider. This is considered a preventive service.
Medicare also covers smoking cessation counseling for those people with Medicare who have been diagnosed with a disease or condition caused by smoking. In this case, Medicare will pay 80 percent of the approved amount for smoking cessation counseling after the deductible is met. In hospital outpatient departments, you will pay a copay that is no greater than the Part A deductible ($1,288 in 2016).
Medicare Advantage plans will cover all preventive services the same as Original Medicare. This means Medicare Advantage plans will not be allowed to charge cost-sharing fees (coinsurances, copays or deductibles) for preventive services that Original Medicare does not charge for as long as you see in-network providers. If you see providers that are not in your plan’s network, charges will typically apply.
You can receive counseling at the doctor’s office (including physicians, psychologists, and clinical social workers), clinic or outpatient department of a hospital. Counseling must be done by a doctor or an approved Medicare provider.
Over-the-counter treatments for smoking cessation, such as nicotine patches or gum, are not covered. This is because over-the-counter medications are excluded from Medicare Part D coverage by law. However, prescription drugs for smoking cessation are covered under the Medicare Part D (prescription drug benefit).
Note: Medicare will not pay for hypnosis sessions to help you quit smoking.