Telemedicine Cost Share Waiver for Non-COVID-19-Related Services to End for Self-Insured Health Plans

Effective January 1, 2022, the cost share waiver for non-COVID-19-related telemedicine visits will end. This means patients who are covered by a self-insured health plan will once again be responsible for their health plan’s telemedicine cost share if the purpose of the telemedicine visit is anything other than an individualized clinical assessment that results in an order for COVID-19 testing. This change aligns with federal guidance requiring that non-COVID-19-related telemedicine visits be subject to the plan deductible.

This change does not impact the State Health Benefits Program (SHBP) and the School Employees’ Health Benefits Program (SEHBP) or fully insured health plans because these plans must adhere to the New Jersey law that requires cost sharing for all telemedicine visits to be waived until the end of the State of Emergency declared by Governor Murphy.