25-450m Important: Telehealth Benefits Continue Under Our Medicare Advantage (MA) Plans
Date: 05/09/25
Learn more on the difference between MA plan telehealth services vs COVID telehealth waiver
Wellcare By Health Net (Health Net) has received questions from providers about the COVID-era telehealth
fee-for-service (FFS) waiver, which was set to expire in March 2025. We have also been asked if the telehealth benefits provided by the Plan are being terminated.
The answer is no. The COVID telehealth waiver policy only impacts members who are on Medicare FFS and is separate from the telehealth services offered by MA plans. MA plan benefits are set each year and approved by the Centers for Medicare & Medicaid Services for the full contract year.
Key points to remember for MA plan offered telehealth services
If the services are offered through a:
- Telehealth vendor
Our MA plans offer 24/7 virtual access to board-certified doctors via Teladoc, with a $0 copay for services. Covered services include general medical, behavioral health, dermatology, and more. - Network provider
Our MA plans also offer the option of getting telehealth services with a network provider who offers the service by telehealth. In this case, the member will have to pay the cost shares based on their plan benefit in the evidence of coverage. (e.g., if a member receives telehealth services from their primary care physician (PCP), they will pay the cost share/copay for seeing their PCP).
To learn more about telehealth services covered under our MA plans, access the Plan Benefit Materials.
For detailed differences between the waiver policy and plan benefits, refer to the table below or contact Provider Services.
COVID telehealth waiver policy extension
The COVID telehealth waiver applies to members on Medicare FFS. The waiver was originally set to expire on
.March 31, 2025, and is now extended through September 30, 2025.
Topic Area | Pre-pandemic permanent statute for members on Medicare FSS | Waiver for members on Medicare FFS | Wellcare By Health Net MA members |
|---|---|---|---|
Eligible geographic and originating sites | Patients had to be located in a rural area or health provider shortage area and had to be physically located in a specific setting (e.g., physician’s office) to participate in a telemedicine visit. | Patients can be in any geographic area (rural or metropolitan) and in any setting, including the beneficiary’s home, at the time of a telehealth visit. | No restriction on the geographic and originating sites. |
Audio-only services | All telehealth visits had to be performed using real-time audio-visual telecommunications technology, with limited exceptions. | Allows for expansion of audio-only services for evaluation and management visits and other specified services. | Offers both video and audio-only telehealth services. |
Eligible provider types | There were limitations on the types of providers who could perform telehealth services. | Additional providers are allowed to perform telehealth services, including physical therapists, occupational therapists, speech-language pathologists and audiologists. | No restriction on the provider type as long as you have a referral and the specialist is able to provide telehealth services. |
Eligible distant/ provider sites | Providers at Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) could not provide telehealth services to patients in other locations. | FQHCs and RHCs are allowed to serve as distant sites for telehealth services. | No restriction on the distant/provider site. |
Tele-behavioral health visits | Patients had to receive an in-person evaluation six months before initiating tele-behavioral health treatment and also needed an in-person visit annually thereafter. | In-person evaluation is not required prior to initiating tele-behavioral health treatment. | In-person evaluation is not required prior to initiating tele-behavioral health treatment. |
For more information on the policy updates, refer to Telehealth.HHS.gov at Telehealth policy updates.
Additional information
If you have questions regarding the information contained in this update, contact the Provider Services Center at
800-929-9224 for Individual and Employer Group Plans, or 800-641-7761 for Medicare Supplement plans.
This information applies to Physicians and Participating Physician Groups (PPGs).