Your Medicare Coverage

Is my test, item, or service covered?

Smoking & tobacco use cessation (counseling to stop smoking or using tobacco products)

How often is it covered?

Medicare Part B (Medical Insurance) covers up to 8 face-to-face visits in a 12-month period. These visits must be provided by a qualified doctor or other Medicare-recognized practitioner.

Who's eligible?

All people with Medicare who use tobacco are covered.

Your costs in Original Medicare

You pay 20% of the Medicare-approved amount for the doctor's services, and the Part B deductible applies if you use tobacco and you've been diagnosed with an illness caused or complicated by tobacco use, or you take a medicine that’s affected by tobacco. In a hospital outpatient setting, you also pay the hospital a copayment.

If you haven't been diagnosed with an illness caused or complicated by tobacco use, you pay nothing for the counseling sessions if the doctor or other health care provider accepts assignment.

Note

To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount you’ll owe may depend on several things, like other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and the location where you get your test, item, or service.

Note

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

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