This article was revised on October 1, 2021.
To encourage social distancing and increase access to care, Independence continues to offer telemedicine services for our members. This chart provides details about cost-sharing.
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Commercial:
Fully insured
| Commercial:
Self-funded
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Keystone
HMO CHIP |
Medicare
Advantage |
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Primary care provider (PCP) visits
| As of January 1, 2021, member cost-sharing (i.e., copayment, deductible, and coinsurance) is only waived for COVID-19 related in-network and out-of-area telemedicine PCP visits.
| As of January 1, 2021, member cost-sharing (i.e., copayment, deductible, and coinsurance) is only waived for COVID-19 related in-network and out-of-area telemedicine PCP visits. As of January 1, 2021, member cost-sharing was reinstated for all non-COVID related telemedicine visits with PCPs, unless the self-funded group chooses to waive it.
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Specialists visits | Cost-sharing will be waived for all in-network and out-of-area telemedicine visits related to COVID-19 for: specialist; nutrition counseling; speech therapy.
Telemedicine visits with specialists that are not related to a COVID-19 diagnosis are subject to the appropriate member cost-sharing.
| Cost-sharing waived for all in-network and out-of-area telemedicine visits related to COVID-19 for: specialist; nutrition counseling; speech therapy.
Telemedicine visits with specialists that are not related to a COVID-19 diagnosis are subject to the appropriate member cost-sharing.
| $0 copayment for COVID-19 related specialist visits. Regular cost-sharing, as applicable, applies for non-COVID-19 related specialist visits.
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Behavioral health visits | Cost-sharing waived for all in-network and out-of-area telemedicine visits related to COVID-19 diagnosis with a behavioral health specialist. Telemedicine visits not related to COVID-19 diagnosis are subject to the appropriate member cost-sharing.
| Cost-sharing waived for all in-network and out-of-area telemedicine visits related to COVID-19 diagnosis with a behavioral health specialist. Telemedicine visits not related to COVID-19 diagnosis are subject to the appropriate member cost-sharing.
| | As of January 1, 2021, behavioral health copayment applies. The amount depends on the member's benefit plan (in accordance with CMS filed benefits for 2021). Copayment waived if there is a COVID-19 diagnosis through the end of the PA public health emergency.
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MDLive visits | Cost-sharing for all MDLive telemedicine visits continue to be waived until 2021 renewal date for small and large fully insured group commercial members. Upon renewal, MDLive services and cost-sharing will vary based on the members' benefits plan. For standard plans, cost-sharing will remain at $0 post renewal. Large groups with custom plan designs will re-instate cost-sharing post renewal.
| Cost-sharing waived for all MDLive telemedicine visits related to COVID-19. Self-funded customers that have opted to waive cost-sharing on MDLive visits for any diagnosis may choose to continue this waiver through October 31, 2021, or until their 2021 renewal, whichever is first, at which time cost-sharing will be reinstated.
| | Effective January 1, 2021, through December 31, 2021members will have a $5 cost-share for MDLive behavioral health visits and $0 copayment for MDLive PCP visits.
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Medicare Supplement
Telemedicine services are payable as a Medicare covered service for all Medicare-eligible providers as long as the Centers for Medicare & Medicaid Services (CMS) dictates.
Independence is committed to providing our members with access to the care they need during the COVID-19 pandemic. We encourage all Independence members and providers to visit our dedicated COVID-19 webpage regularly for the latest news and updates. We will continue to evaluate member needs as the situation changes.
Learn more
Read more about coverage requirements, billing, reimbursement, and proper coding in the News Articles posted on our Medical and Claim Payment Policy Portal: