Medicare Expands Coverage of Tobacco Cessation Counseling

The US Department of Health and Human Services has expanded coverage of evidence-based tobacco cessation counseling for Medicare beneficiaries, making it possible for all smokers to receive counseling from a qualified physician or other Medicare-recognized practitioner who can help them quit smoking.

 

Previously, Medicare covered tobacco cessation counseling only for individuals with a diagnosed tobacco-related disease or with signs or symptoms of such a disease.

 

The new benefit will cover two individual tobacco cessation counseling attempts per year. Each attempt may include up to four sessions, with a total annual benefit thus covering up to eight sessions for each Medicare patient who uses tobacco.

 

Coverage for smoking cessation prescription medication is currently provided for all Medicare beneficiaries under the Medicare Prescription Drug Program (Part D). The new coverage decision will apply to services under Medicare Parts A and B and does not change existing policies for Part D or any state-level policies for Medicaid or the Children’s Health Insurance Program.

 

Under the Affordable Care Act, effective January 1, 2011, Medicare will cover tobacco cessation counseling as well as other preventive care services, such as colorectal cancer screening and mammograms at no cost to beneficiaries. The Affordable Care Act also provides access to free annual physical examinations so that patients can work with their physician to develop and update personal prevention plans based on their health needs and risk factors.

 

 “Today’s benefit builds on the existing preventive services that are available to Medicare beneficiaries. Giving older Americans and persons with disabilities who rely on Medicare the coverage they need for counseling treatments that can aid them in quitting will have a positive effect on their health and quality of life,” said Don Berwick, MD, CMS Administrator.

 

Of the approximately 46 million Americans who smoke, about 4.5 million are Medicare beneficiaries 65 years of age or older and about another million are covered because of a disability.