Telemedicine Co-Pays Are Back. Now What?

May 27, 2021

As COVID-19 restrictions are lifted around the country, some health insurers are changing their tune on telemedicine. 

Certain health plans that eliminated out-of-pocket costs for telemedicine appointments during the pandemic will now charge patients for virtual visits. For example:

  • In Massachusetts, Blue Cross Blue Shield will begin billing for virtual visits at the same rate as in-person visits as of July 1. 
  • Cigna, one of the largest insurers in the country, updated its telehealth billing guidance as of January 1 to bill for virtual appointments at the same rate as in-office visits.
  • And in Florida, Capital Health Plan’s co-pay waiver for telemedicine visits ended March 31.

The change comes just as many patients and providers have come to appreciate the benefits of telemedicine. 

Three out of four people say they like using telemedicine for doctor’s appointments and are interested in continuing to use it in the future. Early data show that telehealth may benefit insurers too, in the form of cost savings.

Health plans seem to recognize that fact. In a message to members, Blue Cross Blue Shield of Massachusetts touted that hundreds of thousands of members “successfully received care remotely.” The company is even expanding telehealth offerings to “better meet members’ needs.” Cigna has expanded its virtual care coverage too.  

But will expanding coverage help patients if health plans reinstate out-of-pocket costs at the same time? 

In contrast to commercial insurers’ shift, there’s a bipartisan push at the federal level to expand telehealth access for government-insured patients. Congress is considering legislation that would give flexibility to Medicare plans and state Medicaid programs to add telehealth services and explore new payment models. 

Policymakers and payers have the opportunity to apply an important pandemic lesson: access to telehealth benefits patients and payers. But finding a way to extend those benefits requires policies that keep virtual visits affordable for the patients who now depend upon them.

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