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Senior woman consults a e-health doctor with tablet computer sitting in soft chair. In touchscreen, male doctor: With telehealth application patient can reach relevant specialist remotely.

Does Medicare Cover Telehealth?

Like Dorothy famously said, there’s no place like home, especially if you have a lot of doctors, specialists, and appointments. There’s something nice about receiving medical care from the comfort of your living room, and that’s precisely what telehealth allows seniors to do. 

In this article, we’ll explore the benefits of telehealth for seniors on Medicare and what services are covered under Medicare.

Benefits of Telehealth Services for Seniors

Telehealth services have many benefits, including: 

Increased Access to Healthcare for Rural Residents: With limited access to medical facilities in these areas, seniors may have to travel long distances to receive care. Telehealth eliminates the need to travel so you can receive medical care from the comfort of your own home. Telehealth is especially beneficial for seniors with mobility issues or those who find it challenging to travel long distances. By providing access to medical professionals remotely, telehealth helps ensure that seniors living in rural areas receive timely medical care without the added burden of travel.

Convenience and Flexibility: Telehealth appointments can be scheduled at a convenient time for the senior, eliminating the need for travel and waiting rooms. Additionally, telehealth services offer flexibility regarding the type of appointment and medical professional available, as seniors can access specialists from various fields remotely.

Improved Health Outcomes: By providing seniors with easier access to medical care, telehealth can help seniors manage chronic conditions and receive preventative care. Regular telehealth check-ins can also improve overall health outcomes by allowing doctors to catch potential issues before they become serious health problems.

What does Original Medicare cover?

Telehealth Services - Medicare Part B

Original Medicare covers telehealth services under Part B. (There are currently special rules due to the COVID-19 pandemic that Medicare will cover further in this article.) 

Once you’ve met the Part B deductible ($226 in 2023), you’ll only need to pay 20% of the Medicare-Approved Amount for your doctor or healthcare provider’s services. And the good news is, with many telehealth services, you won’t have to pay any more than you would for an in-person visit. 

Telehealth services – such as telephone or video appointments – are covered under Original Medicare in the following circumstances:

  • You live in a rural area and must travel to receive medical care. 
  • You require monthly End-Stage Renal Disease (ESRD) visits for home dialysis.
  • You need to diagnose, evaluate or treat a possible acute stroke.
  • You require treatment for a substance use disorder or to diagnose or treat a mental health disorder.

Medicare also covers virtual check-ins and e-visits. Virtual check-ins are brief audio or video communications to avoid unnecessary office visits. E-visits are another way to communicate with your medical team through a patient portal.

Medicare provides a list of approved services that medical practitioners can provide remotely. 

What does Medicare Advantage cover? 

While each plan is different, and you must confirm with your provider, many Medicare Advantage plans to cover telehealth services. Each plan is required to cover what is covered under Original Medicare. However, many plans expand their coverage to include telehealth services even if you are not in a rural area. 

If attending appointments can be a real challenge, you’ll want to consider a Medicare Advantage plan that provides comprehensive coverage for telehealth services. 

Protecting Yourself From Fraud

Conceptual hand writing showing Scam Alert. Concept meaning unsolicited email that claims the prospect of a bargain Laboratory blood test sample for medical diagnostic analysis

Seniors need to protect themselves from fraud when using telehealth services. Medicare fraud can take many forms, including providers billing for services not provided or charging for unnecessary services. Seniors should always be wary of unsolicited calls or emails offering free medical equipment or services. 

For example, a telemedicine company may call you and offer you a brace. They have not done any or minimal diagnostic testing to determine whether or not you need it. Regardless, you may find yourself the recipient of multiple braces, all charged to Medicare. 

Think of your Medicare number like your credit card – carefully protect it! These criminals can be very sophisticated in how they attempt to defraud seniors. Still, by staying informed and vigilant, you can help protect yourself and ensure you’re only being charged for the services and supplies you receive.

COVID-19 and Telehealth Coverage

Due to the COVID-19 pandemic, Medicare has expanded coverage for telehealth services to help seniors access medical care while minimizing their risk of exposure to the virus. 

These changes include waiving the requirement that telehealth visits occur in a designated healthcare facility, allowing providers to bill for telehealth services at the same rate as in-person visits, and expanding the types of healthcare providers who can offer telehealth services.

It’s important to note that these changes are currently temporary and (at the time of writing) will end on December 31, 2024. Seniors should consult with their healthcare providers as that date draws closer to understanding what telehealth services are covered under their plan and their options for receiving care.

Some of the changes are temporary, while others are permanent. The Department of Health and Human Services outlines those changes here.

Navigating Medicare and Telehealth Services With The Medicare Family

Navigating your Medicare coverage can be a daunting experience, especially for seniors who may not be as familiar with the healthcare system. That’s where the Medicare Family comes in. 

For over 40 years, we have helped seniors understand their Medicare benefits, choose the right plans for their specific needs and make the most out of their telehealth services. We provide personalized guidance and support to ensure seniors receive the care they need.
With our help, you can easily navigate the complex world of Medicare, knowing that you have someone you trust by your side every step of the way. Contact us today to learn more about how we can assist you in navigating Medicare.

Sylvia Gordon, aka Medicare Mama®, is an expert on all things Medicare and Social Security. She is the 2nd Generation here at The Medicare Family and has served on the advisory boards of major insurance companies like UnitedHealthcare®, Cigna, and Anthem. In her free time, she can be found taking care of her animals (dogs, goats, peacocks, chickens), and reading a good book. Learn More.
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