How Medicare Covers Telehealth
Throughout your career as a Medicare agent, you will face hundreds of clients who have a hard time getting themselves to a doctor or hospital. Sometimes this is due to a disabling condition, and sometimes it’s due to a lack of adequate transportation. Telehealth is an ideal solution for anyone who needs a quick check-in with a doctor or a quick prescription.
In The News
Currently, patients cannot rely on Original Medicare for telehealth coverage. Part B will cover telehealth in some very specific cases (where it is medically necessary), but most Medicare beneficiaries will not receive telehealth coverage.
Last month, President Trump signed the CHRONIC Care Act that will make it easier for Medicare Advantage plans to offer telehealth services. This move means Medicare Advantage is going to grow even more in popularity. Those who are more severely disabled, do not have transportation, or live in rural areas will enjoy this extra incentive to enroll in Medicare Advantage.
How It Works
You may have heard of telehealth companies like Teladoc and MDLive. Physicians and nurse practitioners who sign up with these telehealth companies can offer video-chat health checkups. They are able to diagnose illnesses and prescribe medication if necessary. This means anybody (not just seniors and Medicare eligibles) can get a good portion of the health care they need without having to leave their homes. Telehealth doctors can prescribe antibiotics and antiviral medications, dermatology medications, and even mental health medications.
Right now, most Medicare plans will only cover telehealth if the patient is in an “HPSA (Health Professional Shortage Area)” or in a rural area with limited access to doctors offices. In the future, MA plans may provide more coverage than that.
How It Helps
Clients who live far from their doctors or don’t have an easy way to get to their doctors will be more likely to enroll in a Medicare Advantage plan knowing that they can access telemedicine. This is an extra way for you to push Medicare Advantage plans to those who can really benefit from them.