Increasing Access to Telemedicine

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Through September 30, 2020, all member cost-sharing (deductibles, coinsurance and copays) for 24/7 telemedicine visits provided by American Well (www.amwell.com), Doctor On Demand (www.doctorondemand.com) and Teladoc (www.teladoc.com) will be waived regardless of medical diagnosis, including behavioral health services for those feeling high levels of stress or anxiety. This applies to all fully- and self- insured commercial groups and individual products that cover this service under the telemedicine service benefit — both QHDHP and non-QHDHP plans.  

Cost-sharing for virtual PCP visits (including AHN MyChart video visits) will also be waived for all plans and all diagnoses.  

Self-insured customers have to opt out of this waiver by May 27, 2020.

 

Frequently Asked Questions

Does the telemedicine cost-sharing waiver apply to telemedicine for behavioral health services?

Yes. The cost-sharing will be waived regardless of medical diagnosis. This is important given the high levels of stress or anxiety or anxiety members may be experiencing at this time. 

Am I able to opt-out of the telemedicine cost-sharing waiver?

Self-insured customers have to opt out of this waiver by May 27, 2020. 

Is telemedicine an alternative to conventional face-to-face care?

Yes. Telemedicine and virtual visits are effective ways for members experiencing mild symptoms to see a physician quickly and safely, without exposing or being exposed to others. For this reason, we are encouraging and promoting the use of telemedicine as an early line of defense. 

If an individual meets CDC criteria for COVID-19 testing, the telemedicine clinician will refer the patient to a local urgent care or emergency center for immediate testing and management. We are waiving the cost-sharing for these visits to encourage members to seek care in the most effective way. 

Is Highmark making specific recommendations for telehealth, nurse lines, or digital pathways to medical care and diagnosis?

We are waiving all fees for most telemedicine services until December 31, 2020—including behavioral health sessions for those suffering from anxiety during the crisis. Telemedicine is a great way to avoid leaving home when sick and still receive medical assistance. Members should call the number for Member Service on the back of their Highmark card to find which telemedicine service is in network. The Member Service number is plan-specific and is the fastest path to correct answers about their coverage.