Even before the COVID-19 pandemic struck, telehealth medical services were already on the rise. Now that we are in the midst of a health crisis, virtual doctor visits have become much more commonplace.
The thing is however, coverage for telehealth services is not always guaranteed. Depending on the type of medical plan you have, your compensation may vary quite a bit. Let’s compare the different ways that telehealth services are handled under various health care plans or programs.
Coverage for telehealth services among private health insurance providers varies from one payer to the next, depending on the exact insurance plan. Since the COVID-19 pandemic hit, many health plans decided to make telehealth more accessible for a certain length of time. Overall, telehealth coverage among insurance companies is still in the development phase.
Currently, 26 states have regulations in place that require private insurance providers to provide reimbursement to healthcare providers for telehealth services, while 10 others are still considering doing the same. That said, different health insurance providers may have their own coverage allowances when it comes to telehealth, so compensation may not yet be available for many.
Individuals and families who currently have health insurance will need to get specific details about what their particular health plan covers when it comes to telehealth services.
Medicare Part B covers most telehealth services. With Medicare, you will have to pay 20% of the amount for your primary physician care visit or other medical services, as long as the amount is approved.
Before compensation is provided, you will also need to pay the Medicare Part B deductible first. The cost for in-person and telehealth services is the same; you won’t pay any less for telehealth services compared to services in person.
There are limitations as to who can access telehealth services for coverage under Medicare. Patients must live in rural areas that are outside a city center to qualify for telehealth coverage, a rule that was established to ensure that people who live in remote areas are still able to access the specialists they may not have within close proximity.
Patients also have to go to a designated medical facility to connect with telehealth technology for telehealth visits. Video visits made from home, or any place that is not designated an “originating site” are not covered under Medicare.
Right now, telehealth reimbursement policies through Medicaid vary among different states and from plan to plan. The issue of telehealth coverage is still developing.
While some states are allowing Medicaid providers and health plans to provide telehealth services, many others are still in the development phase of their policies when it comes to covering telehealth medical services. Many Medicaid members may still not have access to compensation for telehealth services at this time.
While Medicaid will reimburse doctors for telemedicine services in most states, other programs restrict what the type of healthcare providers are qualified for telemedicine, and in some states, Medicaid limits telehealth coverage to physicians only.
Health Share Ministries
Telehealth benefits under health sharing ministries are much less complex than the other plans mentioned above. With UHSM, all members in a program are eligible for Telehealth services at no additional cost.
When you become a member of a health sharing ministry like UHSM, you can take advantage of basic telehealth visits that all come with a $0 consult fee. Depending on the program you choose, telehealth appointments are 100% eligible for sharing and are available with board-certified health care providers the moment you become a member.
If you are looking for a more convenient, flexible, and affordable way to access health care services like telehealth while also receiving comprehensive healthcare benefits and sharing costs with a faithful community of members, consider making the switch to a Christian health sharing ministry today.