Medicare Part B does cover telemedicine for qualified beneficiaries who live in certain rural areas or areas with limited health care providers.
Medicare Advantage (Part C) plans also cover telemedicine for beneficiaries according to Medicare guidelines. Some Medicare Advantage plans may offer additional telehealth services, such as a 24/7 nurse hotline.
Telemedicine allows health care professionals to diagnose and treat patients at a distance using telecommunications technology that allows for real-time distance communication.
For telemedicine to be covered by Medicare, the Medicare health care provider must be located in one of the following facilities:
As a Medicare beneficiary, you must receive your telemedicine services at an originating site (the location where you get telemedicine services) that is located in one of the following:
Ask your doctor or health care provider to find out if you qualify for Medicare telemedicine based on the above guidelines.
Medicare Part B does cover some psychotherapy services over the telephone or other qualified telemedicine communication channels.
Some of these psychotherapy services include:
Starting on July 1, 2019, Medicare beneficiaries can receive telehealth services at home if the services are for treatment of substance use disorder or a co-occurring mental health disorder.
This is due to the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.1
Typically, Medicare Part B pays 80 percent of the Medicare-approved amount for covered services, and you pay 20 percent of the Medicare-approved amount after you meet your Part B deductible.
In 2019, the Medicare Part B deductible is $185 per year.
Specific coverage rules and costs depend on the type of telemedicine service received and the location of the facility where care is received.
If you have a Medicare Advantage plan, your deductible, coinsurance and other costs could vary. Be sure to check with your plan carrier for more details about your telehealth costs.
Medicare Advantage plans are sold by private insurance companies. They cover everything that Original Medicare covers. So, if your telemedicine services would be covered by Original Medicare, they would also be covered by Medicare Advantage.
Some Medicare Advantage plans offer additional telemedicine services, such as a 24/7 nursing advice line.
In addition to the hospital and medical benefits of Medicare Part A and Part B, Medicare Advantage plans usually cover prescription drugs and may also cover:
A licensed insurance agent can help you find Medicare Advantage plans in your area that cover telemedicine.
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1 American Society of Addiction Medicine. H.R. 6, SUUPORT for Patients and Communities Act. Section by Section. Title II, page 3. Retrieved from www.asam.org/docs/default-source/advocacy/hr6_09-28-18-final-opioid-sec-by-sec_bipart-bicam.pdf?sfvrsn=49d048c2_2.
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