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Change in Telemedicine Coverage Effective January 1, 2021

To our valued FSBP Members:

This has been a year unlike any other. As the COVID-19 pandemic has spread around the world, we all have sought ways to bring healthcare closer to us. To ensure you had access to the care you need, the Foreign Service Benefit Plan modified some of its benefits and implemented exceptions to provide remote care access for our members.

  • We expanded our telehealth partnership with Teladoc (for members in the U.S.) and added telehealth services through vHealth (for members overseas).
  • We waived the exclusion on telemedicine visits with your primary care physician (PCP) or other providers, and covered these visits at 100% in the U.S. and overseas.
What’s the difference between telehealth and telemedicine? When you are utilizing services from Teladoc or vHealth, we refer to this as a “telehealth” visit. When you consult with an established provider or primary care physician (PCP) for clinical services virtually (via video conference or by telephone) we refer to this as a “telemedicine” visit.

We worked with OPM throughout the year and obtained permission to make telemedicine visits part of our regular benefits and waive the exclusion on telemedicine visits with your primary care physician (PCP) or other providers.

With 2021 just around the corner, I want to make sure members are aware of how visits will be covered in the New Year.

Telehealth visits through Teladoc and vHealth will continue to be covered at 100%. You can find coverage details and information to access these services in Section 5(a) and 5(e) of the 2021 FSBP Brochure.

Effective January 1, 2021, telemedicine visits (virtual visits with an established provider or PCP) will no longer be covered at 100%, but will be covered like in-person office visits: subject to the calendar year deductible and paid at 90% of the Plan allowance for in network providers and 70% of the Plan allowance for out of network providers.

Each week, I review reports on the usage of telehealth and telemedicine services – in addition to other categories of care – and your usage of the services will help us as we consider new benefits or further benefit changes for 2022. Care options are evolving and we will continue to do our best to ensure you have access to the care you need.

Have a Safe and Prosperous New Year!

To Your Health,

Paula S. Jakub, RHU
AFSPA CEO

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