What is Telemedicine?
Perhaps the biggest change that is already taking place is the spread of virtual and online medical care by physicians. Currently, more patients have access to virtual visits than ever before and many insurance companies have full coverage.
There is no set standard for private health insurance, so the details of telemedicine coverage depend on the plan you choose. Health insurers are now required to cover the cost of telemedicine, and they are prohibited from imposing costs on network operators – and from sharing them with others. Coverage has improved in recent years, making virtual care widely available, and most insurance providers encourage patients to use telemedicine whenever possible.
Blue Cross and Blue Shield of Illinois offer behavioral health telemedicine services through their Behavioral Health and Mental Health Insurance Program (BHIP).
Do All Insurance Companies Cover Telehealth?
In addition, the cost-sharing for medically necessary telemedicine services will be temporarily abolished. Other insurers will push their telemedicine plans without saying when they will stop covering remote visits or start collecting common costs for many – payments and costs. To make matters worse for doctors and patients, employer health insurance is excluded from the extension of telehealth insurance.
In 2012 alone, five states enacted telemedicine care orders, and as of January 2013, 16 states require private insurance plans for telemedicine services. While the state law would not apply to self-insured employer plans, which currently covers more than half of all US workers, private insurers are increasing coverage of telemedicine. Most policies encourage the use of Skype, Google Docs, Skype for Health, and other online services.
In spring 2012, the Innovation Centre announced several Innovation Awards for healthcare, which focus on innovations in health technology such as telemedicine.
Even the federal government is looking at how telemedicine could be used more widely in Medicare. Although some are more advanced than others, we see every day the potential of telemedicine to reduce costs and keep us healthier. Your insurer should inform you how it is insured in your specific policy.
Currently, 26 states have laws requiring private insurers to reimburse health care providers for services provided through telemedicine. In some cases, the federal government’s Affordable Care Act (ACA) health reform law severely limits reimbursement for telemedicine.
Telemedicine laws generally require private health insurers to provide telemedicine services at the same rate as when patients are visiting. The State Policy Resource Center has a list of state laws governing private insurance coverage for telemedicine. Check whether your insurance company accepts this.
The federal government and the states are taking steps to remove barriers to telemedicine services. Medicare provides telemedical services for certain conditions, some of which were temporarily different during the COVID 19 pandemic, such as emergency room visits.
Check with your state’s health authorities whether this flexibility applies to your location and practice, and if so, how much.
If you want to make an appointment for a mentally ill person, ask if they accept your insurance before you call and pay the full amount. If the provider does not accept insurance, we ask you to pay within the scope of your policy. Also, ask if you are billed directly by the insurance company you should just submit a claim for reimbursement to the insurance company.
The largest commercial payers include Aetna, BCBS, Cigna, and United Healthcare. Insurance coverage for telemedicine, including telepsychiatry, is affected by the Department of Health and the Affordable Care Act.
Doctors wishing to offer telemedicine options to their patients should call their payer and ask for telemedicine reimbursement before the service line is introduced. The reimbursement rates for telemedicine are adjusted to the rate of a face-to-face visit, but reimbursement rates vary.
Just as patient care is reviewed, so too are telemedicine visits, which depend on policy.
Right now, especially because of Covid and working hard to curb the spread of the virus, Some health insurance plans, such as Medicare, Medicaid and Medicare Advantage, offer some form of coverage for telemedicine services.
CMS has made it easier temporarily to get services.
Some states encourage insurance companies to take on expanded telemedicine benefits for their members.