The Impact of Teletherapy on Health Insurance Coverage

Teletherapy, or online therapy, offers a convenient way for patients to visit a doctor virtually instead of in person in a clinical setting. Doctors can assess and often diagnose patients via video conference on a tablet, laptop, or phone, or set up a conference call if preferred. Medical doctors and mental health professionals increasingly rely on teletherapy in their practices. 

The popularity of teletherapy is on the rise, especially since the COVID-19 Pandemic and for patients living in remote, rural areas far away from a clinic or hospital. Many insurers now offer teletherapy benefits on par with traditional healthcare, while others cover limited teletherapy sessions, if at all. Patients interested in exploring teletherapy should check with their provider.  

The Rise of Teletherapy During the COVID-19 Pandemic

Teletherapy existed well before the onset of the COVID-19 pandemic, but the global health crisis exponentially raised the demand for virtual healthcare options, particularly mental health services. This surge in demand jump-started a more permanent and widespread appeal for telehealth services that continues today.

The Centers for Disease Control and Prevention reported a 154% increase in telehealth visits during just one week in March of 2020. During this unprecedented event, telehealth providers relied on technology to treat patients, many of whom were experiencing life-changing medical or mental health crises. Telehealth was the only option for many doctors and patients throughout the peak of COVID-19.   

Teletherapy and Health Insurance Coverage

Teletherapy and health insurance coverage saw several key changes in a short period of time, during the COVID-19 pandemic. Insurers needed to act quickly to keep up with the skyrocketing demand for teletherapy services. Federal agencies relaxed HIPAA laws around telehealth, and some states relaxed their interstate licensing laws for teletherapy.

Today, the general landscape of health insurance coverage for teletherapy remains in flux. Some insurers chose to permanently adopt more inclusive telehealth policies, while others restricted policyholders to certain types of telehealth or only covered a finite number of sessions. Insurers in each state generally set their own policies for telehealth coverage.

Limitations in Teletherapy Coverage

Some health insurance providers cover teletherapy, but their plans include built-in restrictions to make finding and maintaining virtual care more of a challenge. Common barriers to telehealth treatment include session limits, copayments, and deductibles. Physicians in some rural or remote areas may not yet be fully equipped with the technology required for telehealth. 

These limitations help insurers provide policyholders with the care they need while ensuring that their medical and mental health providers receive appropriate reimbursement. In exchange for low copays similar to a routine checkup, some insurers allow access to affordable telehealth services, but potentially only for up to a maximum number of sessions, and only after the deductible is paid.

Should You Try Teletherapy?

For many patients, teletherapy can offer a convenient method of treating routine medical and mental health issues.

Advantages

• No commuting necessary: Teletherapy allows patients to see a provider from the comfort of their own homes, which can be especially helpful if they are sick or injured. The convenience of teletherapy also ensures that people who are unable to make the commute due to the cost of traveling or a disability can still receive needed care.
• Helps keep costs low: Telehealth is covered by many insurers as a routine office visit, sometimes requiring only a copay or coinsurance fee. In addition to the savings on the cost of the appointment, patients can also save on travel and parking fees. 
• Decreases the spread of germs: While telehealth was the only way to get medical care and keep germs at bay during COVID-19, this method remains one of the safest today. Seeing a physician virtually instead of in person can help protect yourself and others from contagions and airborne illnesses. 
• Appeals to technology users: Individuals who use technology every day and are adept at learning video conferencing tools might prefer to visit their doctor remotely instead of making the trek to a clinic or hospital. Technology continues to improve the way we use healthcare tools, offering fast and easy treatment methods for tech-savvy patients.

Drawbacks

• Does not work for everything: While teletherapy covers a variety of common ailments and illnesses, your provider may still need to see you in person to properly diagnose and treat your specific condition. There is also no virtual substitute for blood work or X-rays, and if you are a new patient, your practitioner will want to see you in person for your first visit.
• Requires electronic transmission of personal health data: Chances are, your medical records have been transmitted between your providers electronically whether you see your doctor in person or online, but even so, if you are uncomfortable with the virtual sharing of your medical records data, telehealth may not be for you. 
• Insurance may not cover telehealth: Every insurance company is different, and yours may not cover telehealth at all or offer only limited choices that cost you more in copay, coinsurance, or deductible fees. Check your policy for any limitations that may apply to telehealth coverage. 
• Best for tech-savvy patients: Using a telehealth platform to visit your doctor virtually is more user-friendly than ever, but even so, teletherapy does not suit patients with limited technology skills. You may simply prefer to visit your doctor in person rather than relying on technology to dictate your experience. 

How to Find the Best Teletherapy Options Covered by Insurance

A 2021 survey conducted by the American Medical Association estimated roughly ⅓ of patients were hindered by a limited awareness or understanding of their telehealth insurance benefits. Follow these tips to find the best teletherapy options covered by insurance.

• Search online for telehealth benefits: If you do not already have health insurance, a quick online search for this particular benefit can point you in the right direction. If you already have a preferred insurance provider or an active policy in place, search on that provider’s site for teletherapy options. 
• Contact your provider directly: You may try contacting your primary care physician or family doctor to ask about what telehealth options they offer. Providers are steadily adapting their practices to use teletherapy technology, so they may have added telehealth options recently. Then, you can contact your insurance to see if they cover it.
• Call your insurance agent: If telehealth is a priority for you, a broader search for teletherapy options covered by insurance might be your best bet. Consider asking your insurance agent to help you find a variety of policies that include telehealth benefits.

Ensuring You Get the Help You Need

Teletherapy is increasingly popular for its convenience and affordability, especially since the peak of the COVID-19 pandemic. While health providers relied on telehealth services to treat patients during the global lockdowns of 2020, many health providers and insurers have since adopted permanent policies around telehealth benefits.   

Teletherapy can help patients in rural areas or with disabilities get the medical and mental health services they need, from the comfort of their own homes. Telehealth also enables patients to save on the commuting and parking costs associated with visiting a clinic or hospital in person. Most, but not all, health insurance policies cover some form of telehealth providers or benefits.