Does UnitedHealth Group Cover Telemedicine Treatment?

UnitedHealth Group made news in 2015 when they opened some of their insurance plans to cover telemedicine. By 2016, most of the plans covered virtual visits. (Learn More)

Notably, there are states that essentially require such coverage via parity laws. UnitedHealth has admittedly broad coverage due to the companies they have partnered with. (Learn More)

UnitedHealth has partnered with Doctor On Demand, Optum’s NowClinic, and American Well’s Amwell Virtual. Combined, these companies cover 47 states and Washington, D.C.

Virtual visits are cheaper than traditional visits, costing around $50 for most patients. They are usually covered in much the same way that traditional visits to a doctor’s office are. (Learn More)

These virtual visits aren’t for everyone though. Besides clear limitations like needing a phone and needing to be in an area covered by their partners, virtual visits are often best for minor medical issues. You also can’t use a virtual visit for things that require specialized equipment, such as x-rays or blood tests. (Learn More)

Overall, UnitedHealth Group covers telemedicine. If you have questions or concerns about your specific level of coverage, inquire with a company representative. (Learn More)

UnitedHealth Group and Telemedicine

Insurers and telemedicine have a relatively rocky history. Medicare has been restrictive in its coverage of telehealth consultation and treatments. At least one organization, Blue Cross and Blue Shield of Alabama, was at first highly resistant to covering telehealth care of any kind.

However, the times are changing, and insurers are increasingly becoming aware that covering a patient’s virtual visits, which can cost less than $50, can actually save money. Preventative care, which is health care meant to treat a condition or the risk of a condition before it worsens, can be significantly cheaper than an emergency room visit or long-term care that stems from a condition becoming more serious.

It is therefore of no surprise that UnitedHealth Group stepped into the field in 2015, announcing they would cover virtual care visits for self-funded employer customers. They then expanded to UnitedHealthcare employer-sponsored and individual plan participants in 2016.

While their coverage is not perfect for everyone, this expansion was quite significant.

lawmaker

State Parity Laws

State parity laws regarding telehealth influence coverage. These are laws put in place to make sure insurers cover telehealth fairly. They have been enacted in some form in over 30 states.

While the exact mechanics of these laws vary, they generally require an insurer to pay for virtual health care if that same care would have been covered were it performed in person. It should be noted that sometimes the cost to the patient may still be different, as the methodology between virtual health care and traditional health care may vary; therefore, the cost and time required may also differ.

In-Network Doctors

There are several telehealth services available in-network with UnitedHealth Group.

  • Doctor On Demand
  • Optum’s NowClinic
  • American Well’s Amwell

According to UnitedHealth Group, the combination of these organizations allows them to provide services in 47 states and Washington, D.C.

These video-based virtual visits are generally cheaper than other types of visits. A virtual visit often costs less than $50. UnitedHealth claims minor medical treatments (per 2015 figures) tend to cost:

  • $80 when visiting the doctor’s office.
  • $160 when visiting an urgent care facility.
  • $650 when visiting an emergency room.

Virtual visits are subject to deductibles, copays, and out-of-pocket expenses based on their specific benefit plan. They are often treated much like a regular doctor’s visit in terms of cost coverage, but this may vary depending on your specific plan.

Limitations

Telemedicine is not appropriate for all situations. As UnitedHealthcare admits, tests that require specialized machines, such as x-rays, cannot be done via virtual visits.

Virtual visits are usually best for people with relatively minor conditions that are not life-threatening.

They also mention that you should talk with your doctor before and after a virtual visit. This can help you figure out if this type of care is best suited to your needs and to clear up any confusion. This talk can be in person or over the phone.

Finally, you will need a phone capable of making video calls, the appropriate app to make a virtual visit, and a good enough connection that the call can meet a proper standard of care.

How Does UnitedHealth Group Compare?

In terms of its coverage, UnitedHealth Group has a broad area its partners cover, and the cost will be quite reasonable for most people. As telehealth services improve, the benefits of your insurance covering such services will grow as well.

While not without controversy, telemedicine parity laws will protect you from being taken advantage of by your insurance company. It seems likely that these laws will continue to be taken up by more and more states as telehealth exits its infancy and becomes better understood.

UnitedHealth Group’s insurance plans are competitive when it comes to telemedicine. Inquire with a UnitedHealth Group representative regarding the particulars of coverage within your plan.

References

What Is Telemedicine? Chiron Health.

State Legislative & Regulatory Trackers. American Telemedicine Association.

Current State Laws & Reimbursement Policies. (May 24, 2019). Center for Connected Health Policy.

UnitedHealthcare Covers Virtual Care Physician Visits, Expanding Consumers’ Access to Affordable Health Care Options. (April 30, 2015). UnitedHealth Group.

UnitedHealth Widens Telehealth Coverage to Millions of Americans. (May 5, 2015). Forbes.

UnitedHealthcare Telemedicine Reimbursement. Chiron Health.

Virtual Reality: More Insurers Are Embracing Telehealth. (February 20, 2016). Modern Healthcare.

Telehealth Parity Laws. (August 15, 2016). Health Affairs.

Virtual Care: What to Know Before You See a Doctor on Your Smartphone or Computer. (October 18, 2017). UnitedHealthcare Group.

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