Are insurances still paying for telehealth?

Yesterday, a reader from the Worcester area called us up worried. Her neighbor over by Elm Park told her that Medicare might be "cutting telehealth" and she wanted to know if her virtual doctor visits would just disappear come 2027. That's a great question, and honestly, it’s one we get a lot here at our Worcester news desk. So let’s break it down plain and simple, no medical jargon, no confusing gov't language.

If you are asking "are insurances still paying for telehealth?" — the short answer is yes, but with a few catches worth knowing about before your next video call with your doctor.

What Is Telehealth (And Why Worcester Seniors Are Using It More)

Telehealth is basically a virtual doctor visit. Instead of driving down to your PCP's office near Lincoln Square or UMass Memorial, you just hop on a video call, phone call, or send a photo through a patient portal. For a lot of older Worcester residents dealing with icy sidewalks in January or just not wanting to sit in a waiting room, this has been a game-changer.

There are three main types:

● Live Video or Audio Visits – Real-time calls with your doc, just like FaceTiming your grandkids, but it is your doctor.

● Store-and-Forward – You send a pic of that weird rash or a document through your portal, and your doctor looks at it later.

● Remote Patient Monitoring – Your blood pressure cuff or glucose monitor sends readings straight to your clinic automatically.

Massachusetts Telehealth Coverage News: What the Data Shows

According to the 2023 Massachusetts Health Insurance Survey, 34.3% of residents statewide used telehealth last year, and 31.9% of folks 65 and older did too. That's a lot of your neighbors already using this.

But not everybody loves it. 61.7% of people who skipped telehealth said they just prefer seeing their doctor face to face — and honestly, that's fair. Only 40.2% of telehealth users over 60 actually used videos, most stuck with plain audio phone calls. And about 14.9% of Massachusetts seniors don't even have a computer at home, so this ain't a one-size-fits-all solution.

If you or a family member has vision or hearing trouble, take note: 57% of people with those impairments said they struggled with telehealth platforms. So if grandma's having trouble seeing the screen, you are not alone.

Insurance Coverage News: Massachusetts Guarantees It.

Here's the good news for Worcester folks: under Chapter 260 of the Massachusetts Acts of 2020, telehealth coverage is now permanent state law. Your commercial insurance plan HAS to cover medically necessary virtual visits. And your copay can't be higher than what you'd pay walking into an office on Highland Street or wherever your doctor's located.

State data even showed 23% of telehealth visits cost patients absolutely nothing out of pocket. Not bad, right?

Medicare Coverage News: The Payment Parity Question

Now here's where it gets a little murky, and it is the part your neighbor was probably talking about. While Massachusetts guarantees your visit gets covered, that don't automatically mean your doctor gets paid the same rate for a virtual visit as an in-person one. That's called "payment parity" and it is a different animal.

● Behavioral Health: Good news here — Chapter 260 locked in permanent payment parity for mental health visits. Your therapist or psychiatrist gets paid the same whether it’s virtual or in-person, for good.

● Primary Care & Chronic Care: This one is temporary. Lawmakers left the door open for future negotiations, so reimbursement rates for your regular PCP visits could shift down the road.

● Medicare Audio-Only Rules: At the federal level, Congress keeps extending Medicare telehealth flexibilities (like covering phone-only visits) through temporary bills like the Consolidated Appropriations Act. Nothing's permanent yet on the federal side.

What Local Doctors Are Saying

A survey of 181 primary care doctors in a major Boston-area network found 80.9% feel confident using telehealth for chronic condition management, and 89.5% said it helps seniors avoid delays in care. But confidence drops for brand-new diagnoses (57.7%) or urgent visits (60.9%). Most doctors, 74.8%, said telehealth is just trickier with patients 65 and older compared to younger folks. Still, 86.9% plan to keep offering it long term — so it’s not going anywhere.

Information Services for Worcester Residents

Our news service keeps Worcester area seniors and their families updated on healthcare policy changes as they happen — Medicare rule updates, Massachusetts insurance law changes, and what it all means for your wallet. We track state and federal telehealth news so you don't have to dig through confusing government websites yourself.

Bottom Line.

You can count on your Massachusetts insurance covering telehealth visits in 2027, and your copay staying equal to an in-person visit. What ain't guaranteed yet is full payment parity for all primary care and chronic care services long-term — that part's still being hashed out by lawmakers and insurers.

Got questions about how this affects your specific plan? Give us a call, we're happy to help point Worcester families toward the right resources.