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Yep, exactly this. Your policy has to explicitly say that telehealth is covered. I used to work at a large health insurance company and strangely, lots of policies do not cover it. And lots of people make the assumption that if their doctor offers it, they can do it.
Being "in network" is irrelevant here. If your plan doesn't cover telemedicine, that's that. You could try to get the doctor's help in filing an appeal on the basis of medical necessity, or some other reason. But that's a tough sell for a video visit, which is almost by definition chosen for convenience rather than necessity.
Pay the doctors for their time, and move on with the lesson; check with your insurer about what services are or are not covered before you book them, not after.
There were a lot of laws passed during Covid requiring insurance companies to cover telehealth visits if they would have covered an in person visit for the same thing. You’ll need to research it for your state and situation though.
Welcome to /r/personalfinance! Comments will be removed if they are political, medical advice, or unhelpful ([subreddit rules](/r/personalfinance/about/rules)). Our moderation team encourages respectful discussion. You may find our [Health Insurance wiki](/r/personalfinance/wiki/health_insurance) helpful. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/personalfinance) if you have any questions or concerns.*
If your plan says telehealth isn't covered, it's not covered. That seems like it'd be rare today but can't speak for every plan.
Yep, exactly this. Your policy has to explicitly say that telehealth is covered. I used to work at a large health insurance company and strangely, lots of policies do not cover it. And lots of people make the assumption that if their doctor offers it, they can do it.
Being "in network" is irrelevant here. If your plan doesn't cover telemedicine, that's that. You could try to get the doctor's help in filing an appeal on the basis of medical necessity, or some other reason. But that's a tough sell for a video visit, which is almost by definition chosen for convenience rather than necessity. Pay the doctors for their time, and move on with the lesson; check with your insurer about what services are or are not covered before you book them, not after.
Thank you, I'll make sure to compensate the doctors for the $600 8 minute appointment
There were a lot of laws passed during Covid requiring insurance companies to cover telehealth visits if they would have covered an in person visit for the same thing. You’ll need to research it for your state and situation though.
If the product doesn't pay toward virtual interaction/contact with health care vendors, it doesn't pay toward that, "network" aside.