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Telehealth and Insurance

A question we frequently receive from MPA members is how insurance will treat telehealth services. The following is courtesy of our Director of Professional Affairs Paul Berman.

Maryland law requires that every traditional insurance (and only 50% of people actually have traditional insurance) plan in Maryland have a benefit for telehealth to be paid at the same rate as in-person services. The problem is, that only about half of Maryland’s citizens (and in the US) have traditional insurance. The others have what is known as a health plan whose benefits are actually paid by the employer – these are known as self-insured plans. Self-insured plans are not regulated by the states. So, they decide whether they maintain telehealth benefits or not. Traditional insurance cards and self-insured health benefit cards look the same. The only way you can tell is by calling and finding out. Or, you can guess that if the employer operates in more than one state, then most likely the health benefit is not state-regulated.

Bottom line:
Some self-insured companies are pulling back on telehealth coverage. APA and MPA, and others, are advocating for legislation already introduced in Washington DC which would require the self-insured plans to maintain telehealth coverage. But there is no way to know if this will pass.

The bottom, bottom-line:
No one knows. But you can be sure that anyone with traditional insurance will maintain telehealth coverage.