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A Network Health Expert
Due to coronavirus shutdowns, many providers are moving to telehealth services to see and treat patients. We want to ensure our members get the care they need, even if they are unable to see their doctor in person.
Effective March 20, 2020, Network Health will cover telehealth services for a $0 copayment, as directed by the Centers for Medicare & Medicaid Services (CMS), including MDLIVE® virtual visits and telephone and virtual face-to-face visits with in-network providers. For more information, see the Telehealth Services section on our coronavirus information page.
What You Need to Know
- How long will these services be covered at $0 copayment?
Currently, these services will be covered at a $0 copayment through April 30, but we will continue to evaluate that date based on guidance passed down by CMS.
- Do health savings account (HSA) and medical savings account (MSA) members have to meet their deductible before these visits are covered at $0?
No, during the coronavirus shutdown, these visits will be covered at $0 per visit, even before members have met their deductible.
- What are MDLIVE virtual visits?
Virtual visits limit your exposure to illness from others and limits the spread of any illness you may have. Getting medical advice using a virtual visit provides many benefits if you are experiencing non-emergency symptoms. Visit our Getting Care Quickly page for more information.
- Aside from MDLIVE, are other provider telehealth services covered for a $0 copayment?
Yes, provider telehealth services are covered for a $0 copayment. This applies to all telehealth providers for preferred provider organization (PPO) plans and point-of-service (POS) plans and in-network providers for health maintenance organization (HMO) plans. HMO plans do not cover telehealth services with out-of-network providers.The $0 telehealth copayment does not include services for specialists that are excluded from performing telehealth visits, such as physical therapy, occupational therapy, home health and hospice.In addition, we will not cover Medicare non-billable specialties for telehealth visits for Medicare members.
- Which in-network providers offer telehealth services?
This list will continue to grow as we get more information.
- Agnesian – ssmhealth.zipnosis.com
- Ascension – getascensioncare.com/onlinecare
- Bellin – bellin.org/virtualvisits
- Froedtert – froedtert.com/virtual-clinic
- MDLIVE – mdlive.com/networkhealth or visit login.networkhealth.com for single sign on login through the member portal
- Prevea – prevea.com/virtualcare
- Do members have to be an existing patient with a provider/provider office to see him or her virtually?
That is at the discretion of the provider. Typically, providers will only see existing patients virtually.
- Can the coronavirus be diagnosed via telehealth methods?
No, the coronavirus must be diagnosed through a lab test. Telehealth providers can let their patient know whether a lab test is warranted.
- Does the $0 copayment include any labs that may be ordered (ex: the provider says you need to come into the office to have a blood test run)?
No, any labs that are ordered by the telehealth provider will be subject to your plan’s deductible, copayment and/or coinsurance. The exception is the COVID-19 lab test – that is fully covered by your Network Health plan.
For more questions and answers, view the Telehealth Services section on our coronavirus overview page