Telehealth Guidance Documents for Commercial Health Plans

Posted Alliance for Connected Care COVID-19

Commercial Plan Guidance from the Centers for Medicare and Medicaid Services

Commercial health plans have also taken broad actions to increase access to telehealth services during the COVID-19 public health emergency. View AHIP’s list of ways health insurance providers are taking action to respond to COVID-19. 

CMS has issued sets of FAQs encouraging states and private health insurance issuers to increase access to telehealth services. For example, CMS is not taking action against any health insurance issuer that modifies its product to provide greater coverage for telehealth services or reduces or eliminates cost-sharing requirements for telehealth, even if those services are not related to COVID-19. Issuers in the individual and group markets are generally not permitted to modify a health insurance product mid-year.

Guidance for Expanded Telehealth Flexibility for those using HSA-Eligible High-Deductible Health Plans

Section 3701 of the CARES Act provides a temporary safe harbor for providing coverage for telehealth and other remote care services. As added by the CARES Act, it allows HSA-eligible HDHPs to cover telehealth and other remote care services without a deductible or with a deductible below the minimum annual deductible. Section 3701 of the CARES Act also amends the Code to include telehealth and other remote care services as categories of coverage that are disregarded for purposes of determining whether an individual who has other health plan coverage in addition to an HDHP is an eligible individual who may make tax-favored contributions to his or her HSA. Thus, an otherwise eligible individual with coverage under an HDHP may also receive coverage for telehealth and other remote care services outside the HDHP and before satisfying the deductible of the HDHP and still contribute to an HSA.