Does insurance cover smoking cessation?

Does insurance cover smoking cessation? … Possibly! Find out more about health insurance coverage for smoking cessation and how to get help here.

minute read

Quitting smoking is one of the most difficult experiences that many smokers will go through. It can also be somewhat expensive, particularly if smoking cessation aides – like medications and counseling – are used.  So, the logical question to ask next is: Does health insurance cover addiction treatment? To help eliminate or reduce smoking cessation costs, though, you may be able to use your health insurance.  More here, and we invite your questions about insurance for smoking cessation at the end.

Insurance coverage for smoking cessation

More and more health insurance companies are providing coverage for smoking cessation. In doing so, they are saving money, since non-smokers typically have less health problems than smokers. However, keep in mind that in most cases health insurance coverage is limited and won’t cover your multiple smoking cessation attempts. For instance, Medicare Part B only covers 8 visits with an approved doctor for smoking cessation every 12 months. You may also need to have a prescription for smoking cessation medications in order for your insurance company to cover the cost.

More information about your own insurance coverage for smoking cessation can usually be found in your benefits guide. You can also contact your insurance company and ask if smoking cessation is covered by insurance.

Does insurance cover smoking cessation?

While your health insurance may cover smoking cessation, you may still have out-of-pocket costs. This is usually in the form of co-pays or deductibles on counseling sessions and medications, such as nicotine replacement aides and bupropion.

Out-of-pocket costs for insurance coverage for smoking cessation will vary, depending on the company and particular policy. The 2006 Insurance Component of the Medical Expenditure Panel Survey (MEPS-IC), however, found that the average co-pay for a doctor’s visit was $19.33. This is what you may expect to pay for a visit to a counselor or your own doctor for a prescription.

If your insurance company denies coverage for smoking cessation, there are a few things that you can do. First, keep in mind that your insurance company may impose limits on the number of smoking cessation attempts you have in a year. If you’ve tried to quit in the prior year, you may need to wait a short time before attempting to quit again. You can also file an appeal with your insurance company asking for more coverage. In this case, you may need letters from your doctor or other evidence that smoking cessation coverage is a medical necessity for you.

Smoking cessation with no insurance

If you’re trying to tackle smoking cessation with no insurance, don’t give up. There are a number of free smoking cessation programs. Many states now have “quit lines”, which offer smokers tips, advice, and sometimes counseling for free to anyone looking to quit smoking. Some states even send smokers free smoking cessation aides, including free nicotine patches and free nicotine gum. Free online communities for smoking cessation are also helpful and provide smokers with tools, resources, and support that they need to quit smoking.

You might also qualify for Medicaid, a government funded program designed to cover low-income individuals’ medical expenses.  If you qualify, you’ll be able to go to a doctor – usually for free – and get a prescription for a smoking cessation aide.

Finally, if you are unable or unwilling to purchase smoking cessation aides, you can always quit smoking cold turkey. This is somewhat difficult, but it can be done, especially with a great deal of support from your loved ones.

Medical insurance for smoking cessation questions

If you’re one of the lucky individuals with medical insurance for smoking cessation, good for you! If not, don’t give up hope. Remember, where there’s a will, there’s a way and there are things you can do to access addiction treatment without insurance.

Of course, we’re always here to help point you in the right direction and give you support and guidance. Concerns and questions about medical insurance for smoking cessation can be left in the comments below. We’ll do our best to answer you as soon as possible, and we look forward to helping you along the way.

Reference Sources: Smoking & tobacco use cessation (counseling to stop smoking or using tobacco products)
Health Care Reform: The Need for Tobacco Cessation Treatment in the Essential Health Benefits Package
SustiNet Conneticut: Helping Smokers Quit: State Cessation Coverage
ShareCare: Does Your Health Insurance Provide Smoking-Cessation Benefits? Coverage For Tobacco Use Cessation Treatments
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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