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Medicaid reimburses medical and mental health services provided through telehealth at the same rate as in-person services. Private insurance companies may or may not cover telehealth services.
|Reimbursement for: Live video telemedicine and telepsychiatry.||Reimbursement for: Coverage and reimbursement is up to individual insurance carriers.||Illinois doesn’t currently have any parity law, so payers don’t have to cover telehealth services at all.|
Illinois doesn’t currently have any parity laws, so you aren’t protected on reimbursement for telehealth services. However, the state’s guidelines do require that you receive the same level of care you’d receive in person. Illinois Medicaid, provided through the Illinois Department of Healthcare and Family Services, pays for live-video and telepsychiatry services at the same rates as face-to-face visits. Individual insurance carriers in Illinois decide whether they will cover telehealth services.
Medicaid covers a two-provider arrangement, which includes the originating facility, where the patient is, and the distant site, where the doctor rendering the service is located. Medicaid will reimburse out-of-state providers rendering service if they’re licensed in Illinois. The state is a member of the Interstate Medical Licensure Compact and the Psychology Interjurisdictional Compact.
Medicaid only reimburses for live-video telemedicine and telepsychiatry, but it will cover remote at-home uterine monitoring if you’re pregnant and meet specific criteria with prior approval. If a private insurance policy includes telehealth coverage, it must cover counseling from licensed dietitian nutritionists and certified diabetes educators in your own home if you’re a senior with diabetes.
Eligible Health Care Providers
Illinois Medicaid reimburses eligible live-video providers in telemedicine and telepsychiatry, which includes:
Medicaid also reimburses the originating site facility fees for eligible sites, including physician offices, local health departments, outpatient hospitals, and community mental health centers.
Illinois doesn’t have any specific regulations on providing online prescriptions through telemedicine services. Online doctors in Illinois may use their interpretations as to whether they choose to prescribe medications via telemedicine, so you may not be able to obtain necessary medications through this service.
Before you look for an online doctor, confirm with your insurance provider that your policy covers telehealth services. Then, do some background checking to ensure you’ll get the best care at a reasonable cost.
Illinois is still working on expanding access to telehealth, including legislation to enact parity laws for medical and mental health telemedicine. Keep up with evolving telehealth laws in Illinois, including updates in Medicaid and private insurance carrier requirements, by visiting these websites.