Patients Face Unexpected Costs for Telehealth Services, Despite Government Promise

The Trump administration recently announced the elimination of copayments, deductibles, and other barriers to virtual health care for patients during the coronavirus pandemic. Many private health insurers have agreed to eliminate upfront costs for telemedicine, while Medicare and some commercial insurers have agreed to pay the same rate for video calls as for office visits. However, patients across the country are reporting unexpected costs including upfront payment for video appointments and phone calls and full-price charges for services covered by their insurance.

While some insurers are waiving co-pays for in-network doctors or for telehealth services associated with COVID-19 screening, Blue Cross Blue Shield, Aetna, Cigna, and UnitedHealthcare say the proposed telehealth benefits do not necessarily apply to self-insured employer plans, which cover more than 100 million Americans. Governors and state insurance regulators are unable to require those employer-sponsored plans, which are federally regulated, to upgrade telehealth coverage policies.

Some unexpected charges can be explained by loss of revenue to health care providers caused by the economic shutdown. For many doctors, business has plunged, and medical practices may push to collect telehealth revenue immediately from patients rather than wait for insurance payouts.

“A lot of providers may not have agreements in place with the plans that they work with to deliver services via telemedicine,” said Sabrina Corlette, JD, co-director of the Center on Health Insurance Reforms at Georgetown University. “These providers are protecting themselves upfront by either asking for full payment or by getting the copayment.”

Source: Kaiser Health News, April 27, 2020.