Learn About Medicare’s Telehealth Coverage & the Fraud Rising from It

Learn About Medicare’s Telehealth Coverage & the Fraud Rising from It

Medicare telehealth has expanded during the Covid-19 pandemic. As of March 2020, Medicare covers hospital and doctors office visits, mental health counseling, preventive health screenings and other visits via telehealth for all Medicare beneficiaries. For those in Original Medicare, Medicare pays 80% of the cost and the beneficiary or their supplemental insurance pay the other 20%. Costs are similar to in-person care. If you are in a Medicare Advantage plan, contact your plan to see about it’s cost for covered services.

With the expansion of Medicare-covered telehealth, unfortunately also came the expansion of telehealth fraud. This video below is a fun skit by the Stop Senior Scams Acting Program. It shows you how to combat telehealth fraud and the warning signs to look out for.

Some things to remember include:

  • Your doctor should alert you BEFORE your telehealth appointment is scheduled. We’ve heard of cases of beneficiaries being called by a doctor they saw years ago (as shown in this video) to just say hello and ask how they’re doing with the COVID-19 pandemic. These beneficiaries then get a bill in the mail for $180-$430 for a telehealth visit. This is fraud. Legitimate telehealth appointments must be a full visit, similar in timing as a regular office visit.
  • Scammers may try to lure you into a scam telehealth visit so they can steal your personal information, such as your Medicare and/or Social Security number, or trick you into ordering services or medical equipment for which you have no medical need. Consult your doctor if you need equipment.
  • Medicare will never call you and ask for your Medicare and/or Social Security number. They already have it.

If you come across any suspected telehealth fraud or other scams, report it to our California SMP at 1-855-613-7080. Remember, you may be a target, but you don’t have to be a victim!

Karen Fletcher
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.