Center for a Secure Retirement
Does Health Insurance Cover Online Doctor's Visits?

Does Health Insurance Cover Online Doctor's Visits?

Online doctor's visits and other telemedicine services became increasingly popular during the pandemic. And they won't be going away any time soon, even as social distancing guidelines are relaxed or repealed.

Telemedicine offers numerous benefits, according to the U.S. Department of Health and Human Services. For example, it cuts down on patient hassles such as commuting, taking time off work and arranging child care. And online doctor's visits can be life-changing for people with limited mobility, which is more common with age.

This new sector of health care is expanding, but you might be wondering whether it works with your health insurance. Here are answers to some frequent questions about telemedicine and retirement.

Does Medicare Cover Online Doctor's Visits?

Yes, but it depends on the services you need and the condition you're seeking help for.

Both types of Medicare coverage plans — Original Medicare and Medicare Advantage — cover certain telehealth services. As of 2020, Medicare Advantage plans offer benefits that Original Medicare doesn't.

Eligible services covered by Medicare include:

  • Wellness visits
  • Consultations
  • Behavioral therapy
  • Substance abuse treatment
  • Kidney disease and cardiovascular disease treatments
  • Medication management
  • Nutrition counseling

Your health care provider can give you specific information about which telemedicine services are appropriate for you and whether Medicare will reimburse them.

What Will I Pay Out-of-Pocket If I Have Medicare?

You pay 20% of the Medicare-approved amount for online doctor's visits and other telehealth services. Usually, it's the same as what you'd pay for in-person services.

How Did the Pandemic Change Medicare Rules About Telemedicine?

The Centers for Medicare and Medicaid Services expanded Medicare coverage of telehealth services as part of the passing of the CARES Act in March 2020. The agency expanded the eligibility for telehealth services beyond Medicare patients in rural areas to those in all areas of the country, for one. It also began reimbursing doctors for telemedicine services at the same rate as in-person services, and it expanded the list of services that could be provided via telemedicine. Some of the new rules are set to expire when the public health emergency ends, but others have been made permanent.

Does Private Health Insurance Cover Online Doctor's Visits?

Most private insurance plans provide some coverage for telemedicine services. The services covered and how much is covered varies by state and insurance company. Check with your health insurance company before you schedule any online doctor's visits to see whether your policy covers for telehealth and how much it covers.

Telemedicine can give you easier access to health care in retirement and help you manage your health at home. Talk to your health care provider to learn more about how you might benefit from telemedicine and how your insurance can help cover the costs.

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