Telemedicine Coverage - Insurance Providers

Updated: a day ago


Throughout these unprecedented times, TTG is working diligently to not only stay current with insurance offerings and policy changes, but ensuring we are delivering that information to you as timely as possible. See updates below regarding telemedicine coverage for Aetna, BCBS of AZ, Cigna, Humana, and United Healthcare.


We are fortunate that many insurance carriers are covering telemedicine visits throughout this public emergency. As you know, these visits are an excellent way to stay in touch with your patients and support them during this pandemic. Many carriers shared the expense by paying co-pays. Though much of that changed on March 31, 202, telemedicine visits are often still honored.


The below information is for Arizona Carriers.

We have this information for many carriers throughout the country and are happy to send that to you upon request.


Telemedicine/Telehealth Results:


Aetna

  • Telemedicine permitted throughout public emergency

  • Cost sharing is waived for primary care, however, for behavioral health cost sharing expired March 31, 2021.


03/31/21 Update:

  • Commercial Plans - Extended telemedicine coverage due to the COVID-19 public health emergency until further notice.

Medicare Advantage:

  • Member cost-sharing is waived for primary care offices and telehealth visits for the duration of the public health emergency

  • Member cost-sharing for covered in-network telehealth visits for outpatient behavioral and mental health counseling services expired March 31, 2021.


BCBS of AZ:

  • Telemedicine allowed through public health emergency.

  • Cost share waivers continue through public health emergency.

  • Member cost-share waivers for in-network tele-everything services for all diagnosis codes.

  • BCBSAZ individual and fully insured plans and all MA plans are continuing through the duration of COVID-19 public health emergency.

  • Note: MA plans do not cover teledentistry

Reference pdf here for more information.



CIGNA:

  • Telemedicine allowed through public health emergency

  • No cost sharing waivers.

  • For services included in Virtual Care Reimbursement Policy, a number of general requirements must be met for Cigna to consider reimbursement for a virtual care visit. When all requirements are met, services will be reimbursed consistent with face-to-face rates (i.e., parity) to ensure providers continue to receive fair reimbursement as we recover from COVID-19.


Humana:

  • Telemedicine allowed through public health emergency and following CMS guidelines per state.

  • No cost sharing for Commercial plans.

  • Medicare Advantage Plans: Cost sharing waivers apply.

To ease systemic burdens arising from COVID-19 and support shelter-in-place orders, Humana is encouraging the use of telehealth services to care for its members. As of 1/1/21, Medicare Advantage benefits include no member cost share for in-network telehealth visits for primary care, urgent care and behavioral health. For specialty telehealth visits, please verify member plan benefits as any applicable member cost share would apply.


Reference pdf here for more information.


UHC:

  • Telemedicine is allowed through public health emergency.

  • Cost Sharing Waivers: In 2021, cost sharing for telehealth services will be determined according to the member’s benefit plan. Most of our Medicare Advantage plans have $0 copayments for covered telehealth services in 2021.


Optum:

The telemedicine benefits have been extended through June 30th.

Arizona Telehealth rules as of 3.2021: See PDF here and here.