Here’s How TRICARE Is Expanding Telehealth Coverage During the COVID-19 Crisis

Here’s How TRICARE Is Expanding Telehealth Coverage During the COVID-19 Crisis
A virtual health nurse care coordinator reviews patient photos at Brooke Army Medical Center, Fort Sam Houston, Texas, in 2019. (Photo by Jason W. Edwards/Army)

Note from MOAA: Have you been impacted by the coronavirus pandemic, or the response? Share your story to help MOAA understand the needs of the uniformed services community in this challenging time.

 

TRICARE announced temporary policy changes May 19 that expand access to telehealth care. After hearing about telehealth barriers from our members, MOAA urged the Defense Health Agency (DHA) to increase telehealth options for beneficiaries.

 

The move comes as providers across the nation’s health care system are concerned patients with chronic conditions or other medical issues are not seeking care.

 

Some patients, particularly those with underlying conditions, may fear visits to provider offices will expose them to the coronavirus. Others don’t want to contribute to an overburdened health system. Still others are concerned about costs.

 

Three important changes to telehealth coverage will allow more of these beneficiaries to access needed health care services. Some details on the changes, which went into effect May 12 and will remain in place through the end of the COVID-19 national emergency:

 

1. TRICARE will cover audio-only telehealth visits, consistent with Medicare’s coverage expansion during COVID-19. This allows beneficiaries to consult providers who typically don’t offer telehealth services and expands access for those beneficiaries who don’t have video capability or broadband internet service.

 

2. TRICARE has eliminated out-of-pocket costs for covered telehealth services. This copay/cost sharing waiver applies to all covered in-network telehealth services, not just services related to COVID-19.

 

Please consult your managed care support contractor if you have any questions about covered telehealth services. It will take some time to update claims processing, so you may have to pay a copay/cost share up front and submit for reimbursement.  

 

3. TRICARE has expanded the number of providers able to offer telehealth services by allowing reimbursement for interstate care as long as the care is permitted by federal or state licensing laws.

 

[VIRTUAL STORM 2020: Help MOAA Preserve the Military Health Care Benefit]

 

Coverage changes will not be retroactive. For instance, if you had an audio-only telehealth visit before May 12, that claim will not be reimbursed by TRICARE.

 

Changes to regulation involving publication to the Federal Register usually take months to implement. DHA expedited the process due to the urgency of expanding access to care while beneficiaries try to limit their person-to-person contacts. If you have concerns about visiting a doctor or other provider’s office, consider a telehealth appointment.

 

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About the Author

Karen Ruedisueli
Karen Ruedisueli

Ruedisueli is MOAA’s Director of Government Relations for Health Affairs and also serves as co-chair of The Military Coalition’s (TMC) Health Care Committee. She spent six years with the National Military Family Association, advocating for families of the uniformed services with a focus on health care and military caregivers.