February 26th 2024
By Ari Parker
Learn about Medicare coverage for telehealth, what services are included, and who is eligible for telehealth visits.
By Ari Parker
It may not always be possible for you to see your doctor in person. If you have a highly infectious disease, like COVID, or are unable to leave your home due to a condition, you may need to see a healthcare provider virtually. Telehealth services allow you to talk to a healthcare professional using video calls, phone calls, messaging, or another form of digital communication.
Medicare helps pay for certain telehealth services, but there are limitations you’ll want to know about before going virtual. Read on to learn about Medicare eligibility for telehealth, which services are covered by Medicare, and how much you’ll pay.
Telehealth services include care received over the phone or via a video call.
You can get telehealth services covered by Medicare until December 31, 2024. After this date, you’ll need to receive care in an office or medical facility in a rural area to get coverage for most telehealth services.
Telehealth services are medical services conducted using the phone, video, or other digital communication technologies to see a healthcare provider remotely. Many healthcare-related services can be performed virtually, including medical consultations, monitoring, education, and therapy.
Seeing your healthcare provider in a remote setting can be beneficial in situations where you don’t need to be in-person, like for routine check-ups, follow-up appointments, and therapy. Virtual appointments can also be helpful for people who are unable to physically visit a provider in person due to a health condition.
Wait times and traveling to appointments can be exhausting—telehealth services are a convenient way to see your doctor and save some time. Additionally, telehealth services improve access to healthcare, especially if you live in remote or underserved areas.
On the other hand, telehealth services aren’t the best way to treat a condition if your doctor isn’t familiar with your symptoms and needs to see them in-person. Remote visitations are also not the best option if you need medical treatment on the same day.
You must be located in your doctor’s office or a medical facility in a rural area for most telehealth services to be covered. In other words, you’ll have to go to a healthcare location to receive coverage for telehealth services.
If you’re eligible, you can still get Medicare coverage for some medical remote services without living in a rural area. Here are some instances where you can get a telehealth service covered:
Monthly End-Stage Renal Disease (ESRD) visits for at-home dialysis
Remote services for diagnosis, evaluation, or treatment of an acute stroke
Services to treat addiction and substance abuse
There are a number of telehealth services that Medicare covers. We’ve listed the most common services, but it isn’t comprehensive. Check with your insurance provider or healthcare provider to see if Medicare covers a telehealth service you need.
Speech and hearing therapy
Behavioral health services and therapy
Psychotherapy
Office visits
Patient education services
Mental health screenings
Services to manage chronic conditions
In most cases, Medicare treats telehealth services the same as in-person doctor appointments. You’ll pay 20% of the Medicare-approved amount for the remote visit after you meet your Part B deductible.
Here’s how your costs will work if your provider charged $100 for a telehealth visit. If you haven’t met your annual Part B deductible, you’ll owe 100% of the costs until you do. If you have met your Part B deductible for the year, you’ll owe $20 (20% of $100).
A Medicare Supplement plan can help you cover Medicare’s out-of-pocket costs.
Some Medicare Advantage plans offer more telehealth benefits than Original Medicare. You could get remote doctor visits covered no matter where you live, and you may get them covered for a virtual visit from home. Keep in mind that Medicare Advantage plans don’t have standard out-of-pocket costs in the way that Original Medicare does. That means you may have to pay a different out-of-pocket cost for telehealth services depending on your plan. Check your plan's summary of benefits to see what expenses you’d be responsible for.
Telehealth services are helpful for some to receive the healthcare they need. If you’re worried about what you may have to pay for seeing a provider remotely, a licensed Medicare Advisor can walk you through how Medicare helps in your situation. A Medicare Advisor can also help you understand other care options in case you’re ineligible for telehealth services. Call us today at 855-900-2427, or schedule an appointment to get the most out of your Medicare benefits.
