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Does Medicaid and Medicare Cover Telemedicine?

Written by S.O.

Posted on September 23, 2015 at 6:30 am

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Telemedicine, the remote delivery of healthcare services, is growing in popularity. It is vital and a cost-effective way to deliver care to homebound senior citizens and others who have limited access to a doctor due to being in remote locations or other constraints. It can eliminate the hassle of filling prescriptions and diagnosing common illnesses that can take up valuable physician time.

Today, many private insurance companies offer coverage for telemedicine services, and the number is growing daily. If you are on Medicare or Medicaid, you may be wondering if these services are available to you. The answer varies depending on where you live.

If you are on Medicare, the answer is yes, under certain circumstances. There are many telemedicine services including pathology, radiology, cardiology, and others that are covered under the umbrella of “physician services.”

For people who live in rural areas, Medicare will cover physician services using telemedicine, including video-conferencing for a traditional fee for service basis. For the 14 million people who are a part of the Medicare Advantage plan, there is quite a bit of flexibility in using telemedicine as long as this service is offered by their provider.

As of now, the American Telemedicine Association (ATA) is pushing the federal government, the Centers for Medicaid, and Medicare to remove all restrictions that limit telemedicine coverage.

If you are on Medicaid, almost every state provides for some type of telemedicine services. But available services can vary greatly from state to state. As of now, the ATA is also pushing each state to fully cover telemedicine services as a way to increase coverage and reduce overall costs.

Click here to see a state by state analysis of telemedicine gaps, coverage, and reimbursement. If you need more specific information on telemedicine for the state you live in, click here.

In conclusion, the answer to whether Medicaid and Medicare cover telemedicine is a tentative yes, depending on where you live. If you have a policy with a private insurance firm in addition to Medicaid and/or Medicare, 24 states plus the District of Columbia require these insurance companies to cover telemedicine services the same as they would an in-person visit to the doctor. (Ask your benefits manager of your insurance policy to find out if you have this benefit).

There is hope for those who like to look forward, as current Democratic front-runner Hillary Clinton has come out in support of telemedicine, so help for those who lack coverage may soon be on the way.

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