This article was revised on January 13, 2021, to update the coverage position and effective dates.
Expansion of telemedicine coverage
To encourage social distancing and increase access to care, Independence continues to expand its telemedicine services for our members. This chart provides details of the expanded coverage.
Keystone HMO CHIP ||
Medicare Advantage |
Effective March 6, 2020, through March 31, 2021.
Effective March 6, 2020, through the end of the public health emergency, for telemedicine services for in- and out-of-network providers and MDLive®.
Effective March 6, 2020, through the end of the public health emergency, for telemedicine services for in- and out-of-network providers.
MDLive coverage is effective January 1, 2021 through December 31, 2021.
Primary care provider (PCP) visits
As of January 1, 2021, member cost-sharing (i.e., copayment, deductible, and coinsurance) will be waived for COVID-19 related telemedicine PCP visits only.*
For high-deductible health plan (HDHP) members, cost-sharing will be waived for COVID-19 testing and PCP telemedicine visits, which will be covered even if deductible has not been met.
$0 copayment for COVID-19 related telemedicine primary care
$0 copayment for in- and out-of-network providers
Cost-sharing will be waived for telehealth visits related to COVID-19 for specialists visits; nutrition counseling; urgent care; video-only visits for physical and occupational therapy; and audio or video for speech therapy.
Telehealth visits with specialists that are not related to COVID-19 are subject to the appropriate member cost-sharing.
$0 copayment for COVID-19 related specialist visits.
Regular cost-sharing applies for specialist telemedicine visits.
$0 copayment for in-network providers
Behavioral health visits
Based on the member’s benefit plan, cost-sharing will be waived for all in-network and out-of-area telemedicine visits related to COVID-19 with behavioral health specialists.
Behavioral health telehealth visits that are not related to COVID-19 are subject to the appropriate member cost-sharing.
$0 copayment for behavioral health telemedicine visits.
As of January 1, 2021, behavioral health copay applies. The amount depends on the members benefit plan (in accordance with CMS filed benefits for 2021).
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.
As of January 1, 2021, individual consumer plan members will have $0 cost-share based on their 2021 filed plan design.
Keystone CHIP members do not have MDLive coverage.
- As of January 1, 2021, members will have a $5 cost-share for MDLive behavioral health visits and $0 copay for MDLive PCP visits.
- As of January 1, 2021, MDLive telemedicine visits for non-urgent medical conditions will continue to have $0 copay in accordance with our filed benefits.
Cost-sharing will be waived for all telemedicine visits for all PCP and behavioral health visits related to COVID-19 beginning January 1, 2021.
Cost-sharing will be reinstated for all non-COVID related telemedicine visits with a network PCP beginning January 1, 2021, unless the group chooses to waive it.
Cost-sharing is waived for all MDLive telemedicine visits related to COVID-19 through March 31, 2021. Customers that have opted to waive cost-sharing on MDLive visits for any diagnosis may choose to continue this waiver through March 31, 2021, or until their 2021 renewal, whichever is first.
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.
Read more about coverage requirements, billing, reimbursement, and proper coding in the News Articles posted on our Medical and Claim Payment Policy Portal: