What is Telehealth?

One topic on a lot of people’s minds right now is Telehealth? What is Telehealth and how is it covered by Medicare?

Telehealth is the distribution of health services by electronic means. It may be through video or by phone call, as long as it is two-way communication. Telehealth can be used for office visits, consultations, therapy or other medical services. Prior to January 2020, Telehealth was only covered for rural patients and could only be offered in certain healthcare settings, not from home.

On January 1, 2020, Medicare allowed Medicare Advantage Plans to expand Telehealth coverage to non-rural areas and allowed plans to offer Telehealth from home if they desired. Not all Medicare Advantage Plans offer this expanded service, but many do. Check with your Medicare Advantage Plan to find out if you have this coverage.

For beneficiaries with both Medicare and Medicaid, most Medicaid health plans offer expanded telehealth benefits. Traditional Medicaid in Utah also offers Telehealth benefits.

Due to the outbreak of COVID-19, Medicare has temporarily expanded Telehealth coverage for the treatment of COVID-19. The standard Part B deductibles and co-insurance still apply. Your Telehealth visit will most likely cost the same as a standard office visit.

Telehealth is prone to fraud so be sure to check you Medicare Summary Notice or Explanation of Benefits to make sure Medicare wasn’t fraudulently billed for Telehealth services you didn’t receive.

If you have questions about Telehealth or other Medicare benefits, contact the State Health Insurance Assistance Program at (435) 673-3548.