How to navigate your insurance and telemedicine for mental health

March 19, 2020

Originally appeared on 9News

By: Anusha Roy

Doctors and the Colorado Department of Public Health and Environment are encouraging people to use telehealth while they work to slow down the novel coronavirus.

DENVER — Doctors and the Colorado Department of Public Health and Environment (CDPHE) are encouraging people to use telehealth when they can to avoid a trip into the doctors office or clinic as they work to slow down the spread of COVID-19.

People seeking care for their mental health had questions about insurance coverage.

Here’s what we found out:

Medicare

This week Medicare announced that it is expanding services to cover telehealth for both physical and mental health needs.

The Centers for Medicare and Medicaid Services online wrote: 

“Under this new waiver, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country and including in patient’s places of residence starting March 6, 2020.  A range of providers, such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, will be able to offer telehealth to their patients. “

The expanded services are set to last during the duration of the COVID-19 public health emergency.

Medicaid

Marc Williams with the Colorado Department of Healthcare Policy and Financing said Medicaid does offer coverage for telehealth for both mental health and physical health appointments.

In an e-mail, Williams said the way Medicaid pays for mental or behavioral health visits is a little different than how physical health encounters are paid, but that both are covered and in keeping with Colorado’s parity bill.

What is the parity bill? 

Last year, Gov. Jared Polis (D-Colorado) signed HB19-1269 into law, regarding equal access to care. 

“Mental health conditions and needs are covered on par with physical health needs,” Vincent Atchity with Mental Health Colorado said.

The bill didn’t mandate insurance companies offer telemedicine, but Atchity said if an insurance did offer it physical and mental health services should be equal and cost the same for patients.

RELATED: Why state lawmakers passed a new mental health care law to enforce a law that already exists

What about private insurance companies? 

The rule of thumb here is to call your health care provider or insurance carrier to see if your plan covers telemedicine for both physical and mental health needs, because it varies.

Amanda Massey with the Colorado Association of Health Plans said it’s become more standard for insurance companies to offer coverage for both. The key is to check your policy to see what’s covered.

The Colorado Association of Health Plans works with 11 insurance companies representing more than 3 million Coloradans.

What about those without insurance?

CDPHE suggested looking into Community Health Centers that can provide care for those with Medicare, Medicaid and no health insurance. 

They offer telehealth services too.

Co-pays depend on a person’s insurance or lack of insurance. These centers also have a sliding fee scale to make care more affordable, so that income doesn’t inhibit a person from calling in.

The same rule applies: if a person thinks they have COVID-19, call first – do not show up at a clinic, community health center, hospital or emergency room without calling a health care provider first.

Non-profit groups like the Maria Droste Counseling Center provide mental health services for those with insurance and without, including a sliding scale to make care affordable. They recently have started working on their telehealth services in response to COVID-19.


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