According to the Cancer Council, tobacco has existed for 8,000 years and has been chewed and smoked for around 2,000 years. In 2020, 46 million Americans smoke, and about 4.5 million are Medicare beneficiaries who are over the age of 65, according to MedPage Today. Many senior citizens started smoking cigarettes at a very young age, considering no one knew the potential harm and diseases cigarettes can cause.
As seniors age, some might begin to have severe health conditions due to the extended time spent smoking cigarettes. Now with that said, will Medicare cover smoke-related diseases?
Cancer and Medicare
According to the Centers for Disease Control and Prevention, 9 out of 10 lung cancer deaths are caused by smoking cigarettes or secondhand smoke. Thankfully, Medicare will generally cover any medically necessary surgery or screening for cancer treatment. Medicare Part A will cover inpatient care, such as surgeries and cancer radiation treatments, for your hospital stay.
Medicare Part B will cover your outpatient services, such as lung cancer screenings, to detect any hidden symptoms of lung cancer. If you meet the specific requirements for these screenings, such as you’re aged between 55-77, you are a current smoker or was in the past 15 years, and you receive a written order from your doctor, then you will pay nothing for this service (if your doctor accepts Medicare assignment).
Medicare will only cover services and procedures that are considered medically necessary. With that said, Immunotherapy is often used for lung cancer patients, which helps your immune system fight against cancer. Immunotherapy includes medications and vaccines that will boost your immune system response to cancer cells, according to the National Institute of Health (NIH). If your doctor deems Immunotherapy medically necessary, then Medicare should provide coverage.
COPD and Medicare
Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease that blocks airflow from the lungs, causing breathing difficulty, mucus production, and wheezing. What usually causes COPD is prolonged exposure to gases, or most often, smoking cigarettes. People with COPD have an increased chance of developing heart diseases, lung cancer, and other chronic conditions.
Fortunately enough, Medicare Part B will cover pulmonary rehabilitation programs if you have been diagnosed with moderate to severe COPD. This rehabilitation service will help you breathe better while also making you overall stronger. In order for Medicare to cover its share for this program, you must receive this service in a doctor’s office or an outpatient setting with pulmonary rehabilitation.
Now, you must obtain a referral for pulmonary rehabilitation from the doctor treating your COPD. If you receive these services in a doctor’s office, you will pay 20% of the Medicare-approved amount, and the Part B deductible will apply. If you partake in the rehabilitation program in a hospital outpatient setting, you will pay a copayment per session.
Medicare Part B also covers oxygen therapy, which is also widely used for COPD patients. Medicare Part B will help cover the oxygen supplies and equipment. However, Medicare will only pay if a certified durable medical equipment supplier provides the oxygen therapy. For oxygen therapy, you will pay a 20% coinsurance once you have met the Part B deductible.
Smoking cessation counseling
If you are on Medicare and smoke tobacco, you can receive counseling from a qualified physician or Medicare practitioner that will help you quit smoking. Medicare Part B will cover eight in-person visits of smoking and tobacco-use cessation counseling for 12 months.
If you qualify for smoking cessation counseling, and your doctor accepts Medicare, Medicare will cover 100% of the Medicare-approved amount. Therefore, you will not have to pay a deductible, copayment, or coinsurance for the counseling sessions. Medicare Advantage plans are also required to cover smoking cessation counseling without any cost-sharing, but make sure the doctor is in your network.
If you or a loved one need help starting a new tobacco-free life, reach out to a friend or family member for support or call 800-QUIT-NOW to connect with a qualified counselor in your state.
