Which Medicare Plans Cover Telemedicine?

There are two Medicare plans that cover telemedicine services, Medicare Part B (Medical Insurance) and Medicare Advantage (sometimes called Medicare Part C).

Medicare Part B covers certain telemedicine services.  Prior to Coronavirus, telehealth services covered under Part B were reserved for beneficiaries who lived in designated rural areas and required a necessary medical consultation. However, since the emergence of Coronavirus, The Center for Medicare and Medicaid Services (CMS) has expanded telemedicine services to include all places of residence. For most telemedicine services beneficiaries are responsible for 20% of the cost of the virtual visit and the Part B deductible.

Individuals with Medicare Advantage plans typically have the same Medicare telemedicine coverage as those who have original Medicare.  However, since Medicare Advantage is offered through private insurers some MA plans will have expanded telemedicine services.  Some providers are even waiving fees for virtual coronavirus screenings.  If you have a Medicare Advantage plan it is best to check with your provider for services and fees. 

What Services are Covered?

Under the 2020 Medicare telemedicine expansion, a wide range of services are now covered for virtual visits. Here are some examples of telemedicine services Medicare covers:

• Doctor’s office visits
• Coronavirus screening
• Occupational Therapy Evaluations
• Physical Therapy Evaluations
• Group Psychotherapy
• Speech Therapy
• Therapeutic Exercises

Healthcare Professionals that can Provide Telehealth Services

• Doctors
• Nurse Practitioners
• Clinical Psychologists
• Speech Therapists
• Occupational Therapists
• Licensed Social Workers

What Types of Virtual Services are Offered?

According to CMS, there are three main telehealth services physicians and other medical professionals can provide that are covered under Medicare. 

1. Medicare Telehealth Visits:  a visit with a provider that uses telecommunication systems between a provider and a patient.

    

2. Virtual Check-Ins:  a brief (5-10 minutes) check in with your practitioner via telephone or other telecommunications device to decide whether an office visit or other service is needed. A remote evaluation of recorded video and/or images submitted by an established patient.
3. E-Visits:  communication between a patient and their provider through an online patient portal.

Are there any Restrictions?

Previously telemedicine services were limited to those who lived in rural areas and required necessary medical consultations with a healthcare provider, or for those staying in a nursing home or hospital-based dialysis facility.  However, in March 2020 the White House Administration signed into law the Coronavirus Preparedness and Response Supplemental Appropriations Act which expanded telehealth services.  Under the expanded services, Medicare beneficiaries are eligible for telemedicine services regardless of their location. The coverage expansion is available as long as Coronavirus remains a threat.  It is unclear whether the services will become permanent.

Medicare Telemedicine Benefits

Telehealth services are especially beneficial to individuals over the age of 65 who are most vulnerable to Coronavirus. Sheltering in place has made it difficult for many seniors to receive necessary health services. Through the expanded benefits of Medicare telemedicine, a wide range of healthcare services are now possible from the safety of your home.