Telehealth to Medicare Advantage

CMS https://www.cms.gov has finalized policies that will increase plan choices and benefits, and allow Medicare Advantage plans to include additional telehealth benefits starting in plan year 2020. The additional telehealth benefits offer patients the option to receive healthcare services from their homes rather than requiring patients to go to a healthcare facility.

Until this year, seniors in Medicare could only receive certain telehealth services if they lived in rural areas. Starting this year, Medicare began paying for virtual check-ins across the country which means that now patients can connect with their doctors by phone or video chat.

With the final rule, it will be more likely that plans will offer additional telehealth benefits outside of supplemental benefits. This means that the plans will be able to offer additional telehealth benefits with more providers and in more parts of the country whether they live in rural or urban areas.

The final rule will also improve the quality of care for beneficiaries dually eligible for Medicare and Medicaid who participate in “Dual Eligible Special Needs Plans” (D-SNP). These beneficiaries usually have complex health needs and if they have issues concerning their healthcare or need information related to items and services, they may have to work with both Medicare along with Medicaid for information on benefits.

The final rule will create one process across Medicare and Medicaid which will make it easier for enrollees in certain D-SNPs to navigate the healthcare system. The final rule will also require plans to more seamlessly integrate Medicare and Medicaid benefits across the two programs.

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