In California, your telehealth services are covered in much the same way as in-person services. Both Medi-Cal and private payer insurance cover all telemedicine services. Parity laws specify that telehealth is reimbursed at the same rate as in-person services.
|Reimbursement for: All telehealth services||Reimbursement for: All telehealth services||Reimbursed at the same rate as in-person services|
Parity refers to a set of laws created to help Americans get access to affordable health care services. Simply put, they require health insurance plans to cover two types of services equally. California’s telehealth parity laws ensure you get reimbursed for remote care at the same rate as in-person visits and don’t permit insurance plans to require in-person contact for coverage.
In California, Medi-Cal and private payer insurance cover all telehealth services, making it easy to receive care from an online doctor. Service plans cannot limit the setting where services are provided for either the health care provider or the patient. For both Medi-Cal and private payer insurance, telehealth services are subject to the terms and conditions outlined in your contract. To be covered by Medi-Cal, your service provider needs to be located and licensed in California.
Neither Medi-Cal nor private payer insurance limits which health care providers get reimbursed for telemedicine services, as long as the services are clinically appropriate and rooted in evidence-based medicine. The types of providers that qualify include:
An examination is required for a doctor to call in a prescription, however this doesn’t have to be in person. Examinations can include a telehealth interview, self-screening tool, or questionnaire. Prescriptions can be filled remotely through telepharmacy services and dispensed through remote dispensing site pharmacies.
When you require health care services, it’s important to choose a qualified medical professional who fits your coverage needs and meets your expectations. Here’s what to weigh when you’re selecting an online doctor for telehealth services:
For more information about telemedicine services in California, you can reference these sources: