Does Medicare Cover Telehealth Visits?

Telehealth visits have become increasingly popular since the COVID-19 pandemic. Even as things have gotten back to “normal,” many people have decided they enjoyed the flexibility of a telehealth visit versus having to commute to a physical location. It can be very convenient and save you time and energy.

We often get asked if telehealth is something that Medicare covers. The Medicare program made temporary changes to allow more people to utilize telehealth during the height of the pandemic, and fortunately, it has since made many of those changes permanent. This is very beneficial to individuals who have a hard time arranging transportation to and from doctor’s offices.

What Is Telehealth?

Telehealth is the method of delivering healthcare remotely by using modern technology. 

Telehealth visits can be completed by phone, video calls (Zoom, Google Duo, Microsoft Teams, FaceTime, etc.), email, or secure text messaging. It allows patients to receive care from the comfort of their own homes - or wherever they happen to be!

Often telehealth services include routine wellness checks, mental health counseling, nutrition counseling, and medication management.

A variety of healthcare professionals utilize telehealth. For example, individuals may see their primary care physician, therapist, nurse practitioner, physician's assistant, or speech-language pathologist.

Telehealth and Original Medicare

Medicare Part B does offer coverage for telehealth services. The Part B deductible will apply. Once the deductible has been met, the beneficiary will be responsible for 20% of the cost, assuming there is no other coverage like a Medicare Supplement or Medicare Advantage plan.

At the start of the COVID-19 pandemic, providers had the option to reduce the cost or entirely waive the patient's portion. This option continues today, and many clinics continue to offer it as a cost-savings measure for their patients.

As we mentioned earlier, telehealth visits were not always an option for everyone. Prior to COVID-19, they were reserved for those in rural parts of the country. Even then, care had to have originated from a rural clinic, not the person’s home. Beneficiaries in urban areas were not eligible for telehealth services at all.

Now, all Medicare beneficiaries can receive telehealth care for:

• Diagnosis, evaluation, and treatment of an acute stroke
• Monthly home dialysis for End-Stage Renal Disease
• Treatment of substance abuse disorders or mental health disorders
• Services delivered by audio devices
• Emergency visits
• Routine check-ins

Telehealth and Medicare Advantage

As you know, Medicare Advantage plans offer additional coverage outside of Original Medicare. These plans are required to have at least as much coverage as Parts A and B and usually have much more. It's no different with telehealth.

Medicare Advantage members have been able to enjoy telehealth services before the pandemic. They also provide coverage for telehealth in more situations other than the ones described above.

Coverage for telehealth services will vary by plan, but nearly all (about 98%) plans cover this service. There are often no out-of-pocket costs for telehealth visits under a Medicare Advantage plan.

Which Providers Can Offer Telehealth?

Any provider that bills Medicare can also perform telehealthcare - dermatologists, cardiologists, gynecologists, endocrinologists - just about any of the medical "-ologists"!

Telehealth has made receiving care much more accessible for many people. The wider acceptance and use of telehealth is one good thing that came from the pandemic. Of course, there are still hurdles to overcome, but it has provided another way for individuals to get the care they need.