Effective January 1, 2022, telehealth visits (for medical or mental health services) will be covered by the Northern New Jersey Teamsters Benefit Plan as follows:
- If the telehealth provider is a Network provider, coverage will be provided at the same level as any other in-person in-network office visit, including applicable copayments and network deductibles and a limit of one office visit per day. Please refer to your Northern Plan summary plan description for additional information regarding coverage for office visits.
- If the telehealth provider is a Non-Network provider, coverage will be provided at the Plan's Out-of-Network maximum allowance for telemedicine visits, which is approximately $115 based on the current network rate with Horizon Blue Cross Blue Shield (this rate is subject to change). The Non-Network deductibles will also be applied to telehealth visits, and coverage is limited to one telehealth visit per day, as is the case for in-person office visits.
As with all benefits, telehealth visits will be covered only if “medically necessary” as defined in the Northern Plan summary plan description and are subject to all other terms and limitations set forth therein. Telehealth services are covered services that would have normally been performed in an office visit setting. Telehealth services are not covered for services that would have been performed in an out-patient hospital setting or for clinic or hospital visits.
If you have any questions about telehealth visits or your other benefits under the Northern Plan, please contact the Plan Office.