Patients to Pay More Out of Pocket for Virtual Care

Some health insurance reimbursement changes that helped fuel virtual care’s rapid rise during the early months of the pandemic are being eliminated. Health insurance giants UnitedHealthcare and Anthem are revising their telehealth reimbursement rules in ways that will increase patients’ out-of-pocket costs.

Anthem will stop waiving the cost of copays, coinsurance and deductibles for costs related to COVID-19, according to a recent Stat News report. Meanwhile, UHC is ending a virtual visit benefit that had been expanded to many of its members during the pandemic through which the payer covered the full cost of visits for those who sought in-network providers for conditions not related to COVID-19.

Exactly how much more UHC and Anthem customers will pay for virtual visits will vary by plan depending on the new terms of cost sharing in the contracts. These types of changes could have a negative impact for providers. Some patients may forgo care over cost while others who opt for virtual care may be surprised after treatment that they owe more than they had anticipated. Likewise, the continually shifting dates and rules of these plans only adds to patients’ uncertainty as they decide whether to seek care and when.

Some commercial payers, including CVS Health and BlueCross BlueShield of Tennessee, have decided to extend their expanded telehealth coverage until the end of the year. Whether these companies again will extend expanded telehealth coverage into 2021 is unclear.