Updated: Apr 4, 2021
My physician is offering telehealth appointments for patients who would prefer not to visit the office. I am interested, but will Medicare cover these telehealth appointments?
-Emi (Tucson, AZ)
Dear Emi, In short—yes! Medicare is currently covering telehealth appointments with providers who accept Medicare. Let’s discuss some of the details: A telehealth service is a full visit with a provider using telephone or video technology that allows for both audio and video communication. Usually, Original Medicare only covers telehealth in limited situations:
You live in a rural area and travel from your home to a local medical facility to get telehealth services.
You require telehealth services to treat behavioral health conditions, including substance use disorder. You have the option of accessing telehealth services from your home or from a medical facility.
You require telehealth services to diagnose, evaluate, or treat symptoms of acute stroke. You have the option of accessing telehealth services from your home or from a medical facility.
During the current public health emergency, however, Medicare has expanded coverage and access to telehealth. During the emergency period, Medicare covers your hospital and doctors’ office visits, behavioral health counseling, preventive health screenings, and other visits via telehealth in settings that include your home. Telehealth services can also be used for the face-to-face visits required for Medicare coverage of home health care and hospice care. Standard cost-sharing may apply. For example, those with Original Medicare owe a $203 Part B annual deductible and a 20% coinsurance for most medical services. If you have a Medicare Advantage Plan, you should contact your plan to learn about its costs and coverage rules. Certain telehealth services can now be delivered using only audio, including:
Counseling and therapy provided by an opioid treatment program
Patient evaluation and management
If you have questions about technology requirements for telehealth services, you should ask your provider. When deciding whether you would rather visit your physician in-person or via telehealth, know that both will be covered by Medicare, so long as the physician accepts Medicare. -Marci
Article Submitted by:
Stephanie Kirk, Owner, JC Madison Inc.
Insurance ~ Annuities ~ Employee Benefits
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