Guide to Medicare and Telehealth Services

Guide to Medicare and Telehealth Services
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Guide to Medicare and Telehealth Services

Guide to Medicare and Telehealth Services
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In recent years, telehealth services have become an increasingly popular way to see be able to see your doctor. It allows you to have access to medical help and advice without needing to go to the doctor's office. More recently, the covid-19 pandemic pushed the use of telehealth visits further into the public eye and has helped people maintain a certain level of care with their health care providers without putting themselves at risk. Telehealth has changed the way doctor's visits are being done but what is the cost of telehealth? Does Medicare cover the cost of telehealth visits?

If you're over the age of 65 and currently enrolled in Medicare (Original Medicare or Medicare Advantage) or Medicaid, you might be interested in taking advantage of telehealth services, but might be wary of pursuing it out of fear of what it might cost you. As such, it's worth discussing: What exactly is telehealth, and can Medicare and Medicaid help cover it?

What Is Telehealth?

Telehealth, or telemedicine, as it is sometimes called, allows for patients to visit with your doctor without ever having to leave the comfort of your home. This can be done over the internet via your own personal cell phone, computer or tablet or, sometimes, a tablet or device provided to you by the health care facility. Telehealth goes far beyond simply chatting over video, as well: Some telehealth services also allow for patients to send and recieve instant messages with their health care provider, and others allow doctors to take your vitals remotely with a paired device.

With the ongoing threat of COVID-19 and the sheer number of patients who cannot leave their homes because of the coronavirus (or simply because they lack transportation or mobility), telehealth and telemedicine are completely revolutionizing the way healthcare is provided in the modern age. The question remains, though: What does telehealth cost you under Medicare and Medicaid?

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What Do Medicare and Medicaid Typically Cover?

Because there are a couple of different Medicare — Original Medicare and Medicare Advantage — and several different parts — Part A, Part B, Part D, etc. — it can be hard to know exactly what is covered by your specific plan. The same goes for Medicaid, as well. Regardless of if you have Medicare or Medicaid (or, in some cases, both), it's important to know what's covered under your plan. Here's a breakdown of what is typically covered under the plans.

Medicare

Part A:

  • Inpatient hospital care

  • Nursing facilities

  • Hospice services

  • Lab testing

  • Surgery or other operations

  • Home health care services

Part B:

  • Outpatient care

  • Medical equipment

  • Home health care services

  • Various preventative and screening services

Part C (a.k.a. Medicare Advantage):

  • Vision

  • Hearing

  • Dental

  • Fitness

  • Transportation

  • Over-the-counter drugs

Part D:

  • Prescriptions

  • Treatment drugs

  • Savings on other drugs

Medicaid

  • Inpatient and outpatient medical care

  • Nursing facilities

  • Home health services

  • Laboratory and X-ray services

  • Pediatric services

  • Transportation

  • Other optional services as determined on a state-to-state basis

When Can Medicare and Medicaid Cover Telehealth Services?

You'll notice that telehealth isn't listed by name anywhere under Medicare and Medicaid coverage, which might be an immediate cause for concern for you. Fear not, though: Telehealth can be included under both forms of coverage. With Original Medicare, telehealth visits will cost you around the same as an in-person service. This means 20 percent of the Medicare-approved amount for the service, and the Part B deductible does apply. For Medicare Advantage, telehealth services will typically see more coverage compared to Original Medicare.

As far as Medicaid is concerned, the answer will depend on which state you're in. The federal government does not list telehealth as a distinct service, and, as such, it's up to each state to decide individually whether they'd like to cover telehealth services. The Centers for Medicare and Medicaid Services (CMS) are working hard to ensure more telehealth services are covered under these respective plans, and as we move forward into a future where telehealth becomes more commonplace, it won't be surprising to see more providers leaning into the benefits of telemedicine — thus encouraging Medicare and Medicaid to be more willing to cover it.

The Bottom Line: A Better Understanding of Medicare and Telehealth Services Providers

There's no denying that telehealth and telemedicine are actively reshaping the way doctors' visits and healthcare services are being done in the current day and age. Medicare and Medicaid are working to make their services more accessible to meet the growing demand for telehealth coverage. If you're not covered yet, don't lose hope. It's possible that you could be covered in the future, or could rework your current plan to better cover your telehealth services needs.

If you have questions about Medicare, Medicaid, or telehealth services providers, consider contacting the experts at PolicyScout. PolicyScout's insurance professionals have the know-how to help you better understand your plan, your coverage, and your benefits under your individual plan. Consider reaching out for a quote today, or get in touch with PolicyScout to further discuss Medicare and Telehealth services.

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