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.
Since January 1, 2011, 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.
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 ($1,184 in 2013).
If you are in a Medicare Advantage plan (private health plan), contact your plan to see what rules and costs apply. Starting in 2012, Medicare Advantage (MA) plans will cover all preventive services the same as Original Medicare. This means MA 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.
For a list of diseases and conditions caused by smoking, click on the link to the Surgeon General’s Report on the Health Consequences of Smoking in the LINKS box.
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 prescription drug benefit (Part D).
Note: Medicare will not pay for hypnosis sessions to help you quit smoking.
For a list of the type of the types of providers Medicare will cover for outpatient mental health services, click on the link in the GO TO box.