Medicare Your Coverage Options

Medicare expanding telehealth services

Written by Diane Archer

The Commonwealth Fund reports that Medicare is expanding its coverage of telehealth services. More older adults and people with disabilities will be able to connect with their doctors virtually. Some believe it will improve access to care and make it easier for doctors to manage people’s care.

Medicare has been behind Medicaid and commercial insurers in its coverage of telehealth serviceslimiting coverage to areas where it is hard to see a doctor. Only 90,000 people enrolled in traditional Medicare benefit from telehealth services. Only people living in rural areas are covered for telehealth services and only in limited situations.

Medicaid covers some telehealth services today in 48 states. And, most states now require commercial insurers to cover telehealth services in the same ways they cover in-person care.

Offering more people access to telehealth adds additional costs to Medicare, according to the Congressional Budget Office (CBO). CBO believes that telehealth would only add to the services people with Medicare receive rather than take the place of in-person services. And, there is evidence to suggest that telehealth may not save money.

Notwithstanding the potential additional Medicare costs, Medicare is now able to cover telehealth for people needing kidney care and acute stroke care, along with people with substance use disorders. They can now get telehealth services from their homes, whether they live in urban, suburban or rural areas, under the Bipartisan Budget Act (BBA) of 2018.

In 2020, Medicare Advantage enrollees also will be able to get telehealth services. CMS believes it can test the efficacy of telehealth through Medicare Advantage, without spending more. However, it’s fair to worry that Medicare Advantage plans very well may use telehealth in place of doctors’ visits as a way to keep their networks narrow and to profit more.

In time, it’s likely that CMS will expand telehealth services further as a way to promote better health, while reducing costs.

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