People With Medicare

Alcohol Misuse Screening and Counseling

What it is:

Alcohol misuse involves the heavy and frequent use of alcohol. It can lead to other serious health complications such as cancer, liver disease, and emotional and mental problems.

The screening is test that involves a series of simple questions asked by your doctor to see if you have a problem with alcohol.

Why the screening is important:

Alcohol abuse is a growing problem. Currently, 1 in 6 people in the United States has a drinking problem. This screening can help prevent you from becoming dependent on alcohol.

Who is covered:

As of October 14, 2011, Medicare covers the cost of an annual alcohol misuse screening if you:

  • Have Medicare Part B,
  • Do not have a dependence on alcohol, and
  • Are alert during any subsequent alcohol misuse counseling sessions.

How often is it covered:

Medicare will cover one screening per year. People who screen positive can get up to 4 brief face-to-face counseling sessions with a qualified primary doctor or provider.

What you pay:

You pay nothing for cost of this service if you have Original Medicare and you see a doctor who "accepts assignment." Doctors who accept assignment agree to accept the amount that Medicare will pay for a visit or service (called the Medicare-approved amount) as payment in full.

If you are in a Medicare Advantage plan, the plan cannot charge you for this service as long as you see an "in-network" provider, meaning a doctor who has an agreement to treat people who belong to the plan. If you use a provider outside your plan's network, it may cost you money.

Learn more about Alcohol Misuse Screening on Medicare.gov

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Information on this web site was compiled from approved materials of the Centers for Medicare and Medicaid Services.