Patients to Pay More Out of Pocket for Virtual Care

Patients to Pay More Out of Pocket for Virtual Care. A credit card with a chip in a credit card reading machine processing a copay patient charge.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.

AHA Center for Health Innovation logo

Related Resources

AHA Center for Health Innovation Market Scan
Health care leaders will gather at the AHA Leadership Summit July 17-19 in San Diego to share transformational strategies and innovative approaches for…
AHA Center for Health Innovation Market Scan
Virginia-based Inova Fairfax Hospital developed an innovative approach to address these issues by implementing what it calls Provider-Only Patient (POP)…
AHA Center for Health Innovation Market Scan
Humana recently said it plans to open about 100 new primary care clinics in a second joint venture with the private equity firm Welsh, Carson, Anderson…
AHA Center for Health Innovation Market Scan
Four leaders of clinical transformation, innovation and marketing from The University of Texas MD Anderson Cancer Center (MDACC) and Texas A…
AHA Center for Health Innovation Market Scan
A new study indicates that social factors, when built into sepsis readmission models, can help predict which patients are at risk of an unplanned readmission…
Advancing Health Podcast
Public
Medicare Advantage or MA Plans are another way for beneficiaries to get Medicare Part A and Part B coverage delivered through private insurance companies.