GLOSSARY · TRUST AND COVERAGE
Telehealth parity, laws that make insurers cover virtual visits.
Telehealth parity is a type of state law that requires private health insurers to cover telehealth services the way they cover in-person care, and in some states to pay the same rate.
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What it means
There are two kinds. Coverage parity requires a plan to cover a service delivered by telehealth if it covers the same service in person. Payment parity goes further and requires the plan to pay the same rate for the telehealth visit as for the office visit. Most states have some form of coverage law; fewer require payment parity, and many laws carve out certain plans or audio-only care.
Self-funded employer plans fall under federal ERISA law and are generally outside state parity mandates. Medicare and Medicaid follow their own telehealth rules, set by Congress and by each state's Medicaid program.
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Why it matters to a brand operator
Most direct-to-consumer telehealth brands are cash-pay, so parity laws do not change their economics on day one. They start to matter when a brand wants to accept insurance, sell to employers, or lower what patients pay out of pocket. In a payment-parity state, an in-network telehealth visit can be paid like an office visit; elsewhere the rate may be lower.
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How Tessic Health handles it
Tessic Health's providers are licensed in all 50 states, and a completed consult costs the brand a flat $25 in every one of them, so the platform cost of a visit does not change with a state's parity rules.
See the published termsRELATED TERMS
Words that come up next.
PBM
A PBM (pharmacy benefit manager) is a company that manages prescription drug benefits for health plans and employers, deciding which drugs are covered, what pharmacies are paid, and what patients owe at the counter.
Formulary
A formulary is a list of medications that a health plan covers or that a clinic's providers prescribe, along with the doses, forms, and prices that apply.
Synchronous visit
A synchronous visit is a telehealth appointment that happens in real time, with the patient and provider connected at the same moment by video or phone.