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Valley Public Radio Staff
Shots - Health News
Tue December 18, 2012
Seniors Looking To Quit Smoking Get More Help From Medicare
Everyone knows that quitting smoking is one of the surest ways to reduce the risk of dying.
But it has taken a long time for some Medicare beneficiaries to get the same kind of help with quitting that's routinely available to people with private health insurance.
The federal health care law requires coverage of preventive treatments that are recommended by the U.S. Preventive Services Task Force, an independent medical panel. The coverage is required in new private plans and those that have lost their grandfathered status under the law, and must be provided without cost sharing to members.
The task force strongly recommends treatment to help people stop smoking.
But even before the health law gave its stamp of approval, many private plans covered such help. In a survey of its members, 97 percent of health plans already offered interventions for tobacco use before the health law passed in 2010, according to America's Health Insurance Plans, a trade group.
However, a recent study by researchers at Georgetown University's Health Policy Institute looked at 39 health plans in six states and found many contracts did not cover treatments suggested by physicians. Beneficiaries often were forced to shoulder some of the cost.
Coverage was inconsistent, the researchers found. For example, while some plans covered all types of counseling, others would cover only individual counseling and not treatment in group settings or over the phone.
Starting in August 2010, the Centers for Medicare and Medicaid Services also began covering smoking cessation counseling for Medicare beneficiaries who smoked but didn't have any symptoms of disease, without any cost-sharing requirements.
Beneficiaries are eligible for up to two four-session smoking cessation counseling attempts a year.
Before that, however, Medicare took a less expansive view. Coverage for tobacco cessation counseling was only available to beneficiaries who had already developed a disease or health problem related to smoking, like heart disease or emphysema.
Talk about closing the barn door after the horse has gone. The previous policy was absurd, says Cheryl Healton, president and chief executive of Legacy, an anti-smoking advocacy group. "The U.S. Preventive Services Task Force clearly understands how effective smoking cessation is in reducing ill health," she says.
Now Medicare beneficiaries don't have to get sick in order to get help to stop smoking.