Does Medicare Cover Telehealth Services?
Yes, Original Medicare covers telehealth visits (also known as telemedicine or virtual visits).
During the coronavirus pandemic, the Centers for Medicare and Medicaid Services (CMS) is covering telehealth office and hospital visits the same way it covers in-person visits, with the typical deductible and copay applying. This coverage went into effect March 6, 2020.1
Previously, Original Medicare didn’t provide much coverage for telehealth—covering only beneficiaries in rural areas who were required to use designated facilities during telehealth visits. In light of the COVID-19 pandemic, however, CMS announced sweeping changes to the current telehealth system.
Does Medicare Advantage cover telehealth services?
Yes, Medicare Advantage covers telehealth services. By law, Medicare Advantage must provide at least the same benefits as Original Medicare, so that extends to telehealth services as well.
Even before the current pandemic began, some Medicare Advantage plans established online portals for virtual visits. Advantage plans may also charge less for a telehealth visit than an in-person visit to your doctor.
If you are in a Medicare Advantage plan, contact your plan’s website for details about how you can access telehealth coverage.
Should I use telehealth services for my doctor visits?
Telehealth services are indispensable in the fight against the spread of COVID-19. It’s a logical way to practice social distancing and avoid potentially crowded medical facilities.
Social distancing is the practice of maintaining distance from others as much as possible to give the virus less opportunity to spread. The goal of practicing social distancing through telemedicine is two-pronged:
- Social distancing helps protect you. Older adults and people with underlying health issues (such as diabetes, lung conditions, or heart conditions) are more susceptible to COVID-19. By conducting doctor’s appointments online or over the phone, you can avoid waiting rooms and reduce your risk of contracting COVID-19. And this applies to all appointments—not just an appointment you’d make if you suspected you had the virus.
- Social distancing helps protect others. Avoiding situations where the virus might easily spread to others keeps COVID-19 from affecting large groups at once. This way, hospitals—and life-saving treatments they provide—won’t become overwhelmed by crowds, giving more people a better chance at survival.
How do I access telehealth services?
First, you’ll need a computer, tablet, or smartphone with audio and video capabilities so you and your doctor can see and hear each other during your telehealth call. Depending on your doctor, you may use an application like Skype, FaceTime, or a pre-established online portal call.
If you have a Medicare Advantage plan, use your plan’s website to navigate to telehealth services (you can also try searching “virtual visit,” “e-visit,” or “telemedicine.”
If you have Original Medicare or can’t access your Medicare Advantage telehealth services, call your doctor and see if you can make a telehealth appointment. If your current doctor isn’t equipped for virtual visits, ask if they can treat you over a phone call instead.
If none of that works, search the Physician Compare tool on Medicare.gov for a provider, then call until you find a doctor who can see you via a virtual visit.
Medicare telehealth: the wrap-up
You may face obstacles when trying to get a virtual visit with your doctor—not only because of the COVID-19 pandemic, but the recent CMS changes to telemedicine coverage and your physician’s capabilities. Don’t give up. The healthcare landscape is shifting rapidly right now, but it's shifting to get you the coverage you need when you need it.
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