Coverage for Billable MyChart Messages

Some health care providers have announced that they will start billing for certain messages submitted by patients through MyChart. US Family Health Plan does not want members to be caught off guard by unanticipated charges for messages they send.

Most MyChart messages you send will not be billed. However, there are times when messages of a nonurgent nature are sent to medical providers that require more time for review and response.

Here are some examples of topics of messages that may be billed:

• A new issue or symptom requiring medical assessment or referral
• Adjusting medications
• Chronic disease check-in and management
• Flare-up or change in chronic condition

Here are some examples of messages that most likely will not be billed:

• Prescription refill requests
• Scheduling appointments
• Messages about an issue addressed during a visit in the last seven days
• Messages that lead to a visit in the next seven days
• Follow-up care linked to recent surgery
• Messages that do not require a response
• Messages that take less than five minutes to answer

Billable MyChart messages are covered by USFHP if they meet the TRICARE policy. Copays apply in the same manner as an in-person or video visit. For example, if a message is billed by a primary care manager, it will be covered as the equivalent of a primary care visit. If a message is billed by a specialist, it will be covered as the equivalent of a specialist visit.

Many health care systems and facilities use MyChart. Here is an FAQ from Johns Hopkins Medicine about the way the health system will implement message billing. Other health care providers may have differences in how and when they bill. For specific questions, call your provider’s office to ask what you can expect from MyChart messaging.