Telemedicine allows healthcare professionals to provide remote medical care. Medicare covers some telemedicine services. People can access these healthcare services without traveling to a medical facility.
Telemedicine, also known as telehealth, gives people access to essential medical care without asking them to travel to a healthcare facility. A person can speak with a doctor on the phone or computer.
Telehealth first evolved in the late
Because of this, Medicare expanded its coverage for telehealth.
Currently, a person can still take advantage of many of these telehealth services under Medicare. This article discusses how telehealth works under Medicare and which elements of the service Medicare covers.
Medicare Part B covers outpatient services and, in most cases, telehealth services.
People with Medicare pay the same amount for telehealth services as they would for in-person services. For standard services, Medicare covers 80% of the cost, while the person covers the remaining 20%, according to the Centers for Medicare & Medicaid Services (CMS).
Typical telehealth services may include preventive health screenings, routine office visits, and mental health services. Per CMS, examples of the various telehealth services that Medicare covers include:
- occupational therapy evaluations
- physical therapy evaluations
- group psychotherapy
- speech therapy
- therapeutic exercises
- doctor’s office visits
However, remote healthcare does not work for all medical concerns, and some services may still require in-person visits. A healthcare professional will assess whether the individual requires further in-person evaluation, testing, or treatment after the initial visit.
If a person needs transportation to a medical facility for follow-up care, Medicare Part B may cover the cost, according to Medicare Interactive.
Part B covers both emergency (ambulance) transportation and limited nonemergency rides. A person can receive nonemergency transportation if they cannot get out of bed or need monitoring in transit to another facility.
A person should check with their policy or doctor to see if Medicare can cover their transportation needs.
People with a Medicare Advantage (Part C) plan generally have similar coverage for telehealth services as those with parts A and B (original Medicare), according to the National Council on Aging. However, some Medicare Advantage plans may offer expanded telemedicine services.
Private insurers administer Medicare Advantage plans, so the exact telehealth services that a person’s plan includes may vary. An individual should determine coverage through their insurance provider directly.
Although a coinsurance for telehealth services usually applies, some medical professionals waive the fees for telemedicine visits for coronavirus screening.
However, not all healthcare professionals promote this policy. A person may want to ask the healthcare professional whether they are waiving fees for coronavirus screening or other services.
In some cases, a person may need transportation to a healthcare facility. Some plans offer nonemergency transportation to a healthcare facility or doctor’s office. A person should check with their provider to find out what transportation needs their plan covers.
In the past, Medicare has placed some restrictions on telehealth coverage.
For example, Medicare formerly covered telehealth services in only certain circumstances, including when a person lived in a rural area and was staying in a facility such as a skilled nursing home or hospital-based dialysis facility.
However, Medicare lifted many restrictions due to the Coronavirus Preparedness and Response Supplemental Appropriations Act, which became law in March 2020.
In the past, changes to the coverage of telehealth services were effective for a calendar year. The emergency legislation and coverage expansion in 2020 does not clearly state whether the changes are permanent.
As a result, a person may want to check with their healthcare professional’s office if they want to continue to use telehealth for the foreseeable future.
Telehealth provides medical services via a remote connection between an individual and their medical provider. Medicare covers various types of telemedicine services.
The Coronavirus Preparedness and Response Supplemental Appropriations Act expanded telehealth coverage during the COVID-19 pandemic. The expanded coverage allows more people to take advantage of telehealth services, even for routine services previously not covered.
A person’s best option involves talking with a healthcare professional directly to determine whether they offer telehealth services and their costs.