Does Medicare Cover Virtual Visits?

Telehealth is a virtual electronic communication technology that allows healthcare providers and patients to communicate with each other without ever visiting in person. This new way of practicing medicine became quite common during the COVID-19 pandemic.

So a common question many people have is, “does Medicare cover virtual visits?” In this article, we answer that question in clear, plain English. You will also find the average costs of virtual visits and other helpful info.

Does Medicare Cover Virtual Visits?

The short answer is yes; Medicare will cover the cost of virtual visits. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your telehealth session. Below we look at what these are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for virtual visits. Coverage for virtual visits is provided by Medicare Part B. Medicare Part B sees telehealth visits as similar to in-person outpatient visits.

Some of the services that you may receive in a telehealth visit may include:

Office visits
Consultations
Psychotherapy

These are some of the healthcare providers that can give you a telehealth service:

Doctors
Physician assistants
Nurse practitioners
Clinical social workers
Nurse anesthetists
Licensed nutritionists
Licensed dieticians

You can either have the telehealth service at your home, or by going to a healthcare facility and having it there.

Medicare Part B covers 80 percent of the costs of your telehealth service. You will pay for the remaining 20 percent.

Part C Coverage for Virtual Visits

Medicare Advantage plans (Medicare Part C) also provide coverage for virtual visits. They cover everything Original Medicare covers, as well as some additional benefits. However, exactly what it covers and what your out-of-pocket costs are will vary depending on the specifics of your plan.

In 2020, Medicare Part C made some changes with regards to their telehealth visit coverage. Additional benefits were added such as access to telehealth benefits from home. All Medicare Part C plans have that benefit. Other benefits added vary depending on the Medicare Part C plan.

How Much Does A Telehealth Service Cost?

Generally, telehealth services are less expensive compared to in-person visits. The exact costs of a telehealth service will differ depending on what type of service you need. Other factors that may affect the overall cost of your telehealth service includes the condition that needs to be treated and the healthcare provider themselves.

What Are The Advantages Of Telehealth?

Telehealth became popular during the COVID-19 pandemic as it was a way to get medical attention without having to leave your home. This can be useful for many reasons, such as if you don’t feel safe in public spaces or if you live far away from medical facilities. Telehealth is also usually less expensive than in-person visits.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.