Is Telemedicine Covered by Insurance?

Many people, not only across the country but around the world, have heard about the benefits of telemedicine. To those who have used telemedicine, the fact that it allows providers and patients to connect during the middle of a pandemic gives it the feeling of a miracle technology! However, if one has not used the technology, but is interested, there is a natural question: Is telemedicine covered by insurance? More often than not, you’ll find the answer is a resounding yes.

Types of Telemedicine

When checking if telemedicine is covered by your state’s Medicaid and private payer insurers, be sure to look for which type of telemedicine is covered. Many states have restrictions on the type of telemedicine they cover. There are three types of telemedicine: Live Video, Store-and-Forward, and Remote Patient Monitoring.

Live video telemedicine is classified as a real-time, interactive, synchronous interaction between a provider and a patient. This is the type of platform used by Beam Health and it is the most widely covered throughout the country.
Store-and-Forward telemedicine is asynchronous, pre-recorded video or image that is shared over a secure email or other file sharing system. Store-and-Forward would be used to share something along the lines of an x-ray.
Remote Patient Monitoring is when a provider can constantly monitor a patient from their home through the use of a Bluetooth device that keeps track of certain metrics such as vitals, blood pressure, and heart rate, to name a few.

Telemedicine with Medicare

As of March 6, 2020, the Centers for Medicare and Medicaid passed the expansion of telehealth with the 1135 Waiver. This allows Medicare to pay for office, hospital, and other visits that are conducted through telehealth in all 50 states. At the time of writing this article, there is no end date for this waiver and, in fact, there is a proposal for it to be indefinite.

Telemedicine with Medicaid

While Medicaid coverage for telemedicine is not required in every state, many are taking the steps for telemedicine to be covered. Most states’ Medicaid allows every telemedicine visit to be charged as if it were an in-person visit. That being said, some states have certain criteria that must be met in order for the visit to qualify. For example, in Alabama, a telemedicine visit must be a synchronous, live video chat (like Beam Health’s live video chat feature) in order to be reimbursable.

Telemedicine with Private Payer Insurance

In order for private insurers to be required to cover telemedicine, a state must have a parity law in place. This requires insurers to cover a telemedicine visit just as they would an in-person visit. At the time of writing this article, there are 39 states that have some form of a parity law in place. If your state does not have a parity in law in place, this doesn’t mean that private insurers do not cover telemedicine, but they are allowed to make that decision at their discretion.

As you can see, there a lot of factors to keep in mind when considering if telemedicine is covered by insurance. Beam’s synchronous live video is widely accepted throughout the country. To learn more about Beam Health and how our telemedicine platform can help your practice, please visit us here to schedule a demo with one of our onboarding specialists!