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Does Medicare or Medicaid Cover Telehealth Services?
Posted: June 19, 2020
Last updated date: December 01, 2022
During the Covid-19 public health emergency, the Centers for Medicare & Medicaid Services (CMS) expanded Medicare telehealth coverage. Whether telehealth services are covered by Medicaid or not may depend on the state where you live. Telehealth is also a useful benefit of many dual health plans.*
Telehealth can help in times when it’s not easy to visit a doctor in person. Or if it’s after normal business hours when your regular doctor may not be available. Read on to find out how telehealth works and when to use it.
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Telehealth and telemedicine have many names
The terms telehealth and telemedicine usually describe ways to visit with a doctor using a computer, tablet or mobile phone. You may have also heard it called virtual medical visits, doctor on demand or by a brand name like Teledoc®. Whatever you call it, telehealth or telemedicine can be a valuable benefit for those with Medicaid and Medicare. That’s why it may be a good idea to shop for a dual health plan that includes telehealth as an extra benefit at no cost to you.*
Telehealth visits can be set up in advance or any time you need
Visit a doctor on demand, 24/7
There are many benefits of telehealth. With telehealth you can:
- Visit with a doctor or mental health provider over the internet.1
- Ask questions and get a diagnosis.1
- Get medicines prescribed 2 and sent to your pharmacy.
- Talk privately about a mental health issue or concern.
- Chat over the phone, or some services also support video.
- Use it any time, any day, anywhere.
- Save when you can get the extra convenience telehealth at no extra cost to you.
When is it a good choice to use telehealth?
Telehealth is a good option to treat common conditions that have standard treatments. Here are some examples:
- Cold, flu, and fever
- Cough, aches, and sore throat
- Allergies, skin rash, and irritation
- Urinary tract/bladder infection
- Ear infections
- Sinus infections
- And more
When is telehealth not a good choice?
Telehealth isn’t for complex, urgent or emergency conditions. An emergency is a sickness or injury that is sudden and puts your life in danger. If you have a life-threatening emergency, call 911 or go to the ER right away.
You don’t need an appointment to use telehealth
Telehealth visits can be set up in advance or any time you need. You may be able see a doctor right away, but wait times can vary. You may also be able to ask to have a doctor call you back. Telehealth visits usually last about 10–15 minutes. Telehealth can be a quick and easy way to get medical care you need. You’ll save yourself a trip to the doctor’s office, too.
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*Benefits and features vary by plan/area. Limitations and exclusions apply.
1 Not all medical conditions can be treated through telehealth. The telehealth doctor will identify if you need to see an in-person doctor for treatment.
2 Doctors can’t prescribe medications in all states. Prescriptions cannot be written for opioids.