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Does Medicare Cover Telemedicine? What Beneficiaries Need to Know
Reviewed by John Krahnert
Medicare covers many telehealth services, and those benefits expanded during the coronavirus pandemic. Beneficiaries can use telehealth to access their doctor while also staying safe during COVID-19.
Telehealth has been around for a while, but your doctor may not have started using it until the COVID-19 pandemic started.
The good news is that telehealth services allow you to see your doctor without having to leave your home. It’s all done virtually. You can receive the same high-quality health care while also being able to stay safe and prevent the spread of the COVID-19 virus.
Medicare Part B and Medicare Advantage plans (Medicare Part C) cover telehealth for qualified beneficiaries, and additional telemedicine benefits may be available to beneficiaries who live in certain rural areas or areas with limited health care providers.
This article explains what types of services you can get via telehealth and what you need to know before a telehealth visit.
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How can telehealth benefit me?
When you have a telehealth appointment, it means you don’t need to travel to your doctor’s office. This is particularly helpful when the weather is bad, if you really don’t feel well or if your doctor is located a far distance away from your home.
Telehealth is also beneficial because it means you may be able to access specialists who aren’t close by. This is especially helpful for people living in rural areas.
In addition, telehealth can keep you safe during the COVID-19 pandemic and at other times because it limits your exposure to other people, which therefore limits your chances of contracting communicable diseases, lowers your risk for exposure to viruses and reduces your risks of falls.
How are telehealth services used during the COVID-19 pandemic?
Many doctors are using telehealth to evaluate patients if they suspect you might have COVID-19. They may also be using it for sick visits and a variety of other low-acuity problems, meaning problems that don’t pose significant health risk to you. This is true for doctors in urban and rural areas.
Some doctors may also use telemedicine services to consult with patients who don’t need to travel in person to the doctor’s office but who can still benefit from the appointment.
When does Medicare pay for telehealth?
During the public health emergency, Medicare added dozens of telemedicine services to its Medicare telehealth list, including office visits, psychotherapy, consultations and certain other medical or health care services.
You’ll be able to continue to receive some of these services via telehealth even after the COVID-19 pandemic has ended, while others have been added for use during the public health emergency only. Some of these services require a video visit while others can be conducted via phone only. Either way, these changes mean it’s easier for you to access telehealth services than ever before.
Medicare Part B covers certain telehealth services for beneficiaries who might lack access to consistent medical care due to a number of factors. It's important to note that Medicare Advantage plans (Medicare Part C) may offer benefits not covered by Original Medicare (Part A and Part B), though the benefits available can vary from one Medicare Advantage plan to the next.
Ask your doctor or health care provider to find out if you qualify for Medicare telemedicine coverage for the services you need.
Does Medicare pay for telephone psychotherapy?
Medicare Part B does cover some psychotherapy services over the telephone or other qualified telemedicine communication channels. As mentioned above, it's important to keep in mind that Medicare Advantage plans may offer more telehealth benefits than what's available through Original Medicare.
Some of the psychotherapy telehealth services that Medicare covers include:
- Individual psychotherapy
- Psychiatric diagnostic interview
- Psychoanalysis
- Family psychotherapy
- Psychotherapy for crisis
Medicare beneficiaries can also receive telehealth services at home if the services are for treatment of substance use disorder or a co-occurring mental health disorder.
How much does telemedicine cost with Medicare?
When Medicare Part B covers certain telehealth services, you will typically pay 20% of the Medicare-approved amount (i.e., the amount your doctor accepts from Medicare as payment) for the services you receive. You’ll also typically be responsible for the Part B deductible.
For most telehealth services, you’ll pay the same amount that you would if you had received those health care services in the office.
If you have a Medicare Advantage plan, your deductible, coinsurance and other costs could vary. Be sure to check with your plan carrier for more details about your telehealth costs.
How can I access telehealth services?
Ask your doctor if they provide telehealth services and whether a telehealth visit is a good choice for your health care condition. You can also search for telehealth companies that provide on-demand virtual appointments with a doctor.
If your condition is appropriate for telehealth, your doctor may schedule you an appointment and provide instructions for how you can attend.
For example, if using video chat, you may need to click on a secure link in an email or text message and then wait for your doctor to log on. In other cases, you may be able to simply provide some information via an online patient portal, and your doctor will respond back to you.
How can I prepare for a telehealth visit?
Preparing for a telehealth visit isn’t much different than preparing for an in-office one, with the exception of making sure your technology (e.g., phone, tablet or computer) is charged and ready to go and that you’re in a place where you can access a secure internet connection.
Many Medicare Advantage plans offer additional benefits
Medicare Advantage plans are sold by private insurance companies and cover everything that Original Medicare covers. So, if your telemedicine services would be covered by Original Medicare, they would also be covered by Medicare Advantage.
A licensed insurance agent can help you find Medicare Advantage plans in your area that cover telemedicine.
About the author
Lisa Eramo is an independent health care writer whose work appears in the Journal of the American Health Information Management Association, Healthcare Financial Management Association, For The Record Magazine, Medical Economics, Medscape and more.
..Lisa Eramo is an independent health care writer whose work appears in the Journal of the American Health Information Management Association, Healthcare Financial Management Association, For The Record Magazine, Medical Economics, Medscape and more.
Lisa studied creative writing at Hamilton College and obtained a master’s degree in journalism from Northeastern University. She is a member of the American Health Information Management Association, American Academy of Professional Coders, Society of Professional Journalists, Association of Health Care Journalists and the American Society of Journalists and Authors.
Lisa currently resides in Cranston, Rhode Island with her wife and two-year-old twin boys.
Website: LisaEramo.com
LinkedIn: Lisa Eramo
Twitter: @Lisa_Eramo
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Your Medicare guide will arrive in your email inbox shortly. You can also look forward to informative email updates about Medicare and Medicare Advantage.
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