Telehealth Pricing


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* PEPM Fee (Per Employee Per Month) for Group Purchase through employer.

Prices for January 1, 2021 start date. Opt-in by December 20, 2020 to secure these monthly fees.

Urgent Care Stand-Alone

PEPM Fee1
Urgent Care Visit Fee2
Urgent Care Utilization Threshold3
$8
$0
N/A

1The PEPM Fee includes one employee and his/her (i) spouse/domestic partner and (ii) legally dependent children up to age 26.

2Urgent Care visits are on-demand (i.e. they are not schedule). Urgent Care visits are capped at three (3) per individual per month under a $0 Urgent Care visit fee pricing model. Each visit above the cap will be charged at MeMD’s then-current standard visit fee rate for the service type, which will be collected at the time of service.

3Urgent Care utilization shall be calculated per calendar quarter based on annualized utilization in the aggregate. If the annualized utilization exceeds the threshold, then the PEPM Fee shall automatically, without notice, increase as follows: $0.05 for every 1% of annualized utilization (calculated per calendar quarter) over the threshold (e.g., add $0.05 if annualized utilization is greater than 20% and less than or equal to 21%)

Urgent Care + Therapy (18+)

Urgent Care
Therapy (18+)
PEPM Fee1
Visit Fee2
Utilization Threshold3
Visit Fee4
Utilization Threshold
$9
$0
20%
$0
N/A

1The PEPM Fee includes one employee and his/her (i) spouse/domestic partner and (ii) legally dependent children up to age 26.

2Urgent Care visits are on-demand (i.e. they are not schedule). Urgent Care visits are capped at three (3) per individual per month under a $0 Urgent Care visit fee pricing model. Each visit above the cap will be charged at MeMD’s then-current standard visit fee rate for the service type, which will be collected at the time of service.

3Urgent Care utilization shall be calculated per calendar quarter based on annualized utilization in the aggregate. If the annualized utilization exceeds the threshold, then the PEPM Fee shall automatically, without notice, increase as follows: $0.05 for every 1% of annualized utilization (calculated per calendar quarter) over the threshold (e.g., add $0.05 if annualized utilization is greater than 20% and less than or equal to 21%)

4Therapy (18+) visit fees shall be paid in full by patients upfront at the time of service. Therapy (18+) sessions are 50-minute, scheduled visits with a Licensed Professional Counselor, Licensed Clinical Social Worker, Marriage and Family Therapist, or equivalent licensed professional. For services provided on an appointment basis, if the patient fails to properly cancel a scheduled appointment at least 24 hours in advance of the appointment or if the patient is late to an appointment causing the patient to miss more than 40% of the allotted time for the appointment, the patient (or legal guardian) will be responsible for up to a $65 missed appointment fee.

Virtual Primary Care Ages 16+

(Includes Urgent Care for All Ages)

PEPM Fee1 (Individual/Family)
VPC Visit Fee2
VPC Utilization Threshold
$16.00 Individual
$24.00 Family
$25
N/A

1The PEPM Fee for Individual includes the employee only (i.e. it does not include the employee’s spouse/domestic partner or legally dependent children up to age 26). The PEPM Fee for Family includes one employee and his/her (i) spouse/domestic partner and (ii) legally dependent children up to age 26.

2Virtual Primary Care Ages 16+ (including Urgent Care) visit fees shall be paid in full by patients upfront at the time of service.

PEPM Fee1 (Individual/Family)
VPC Visit Fee2
VPC Utilization Threshold3
$22.00 Individual
$35.00 Family
$0
100%

1The PEPM Fee for Individual includes the employee only (i.e. it does not include the employee’s spouse/domestic partner or legally dependent children up to age 26). The PEPM Fee for Family includes one employee and his/her (i) spouse/domestic partner and (ii) legally dependent children up to age 26.

2Virtual Primary Care Ages 16+ (including Urgent Care) visit fees shall be paid in full by patients upfront at the time of service.

3Virtual Primary Care Ages 16+ visits are scheduled and, in addition to virtual routine visits, include one (1) virtual wellness visit per Member per 12-month period. Urgent Care visits are on-demand (i.e. they are not scheduled). For services provided on an appointment basis, if the patient fails to properly cancel a scheduled appointment at least 24 hours in advance of the appointment or if the patient is late to an appointment causing the patient to miss more than 40% of the allotted time for the appointment, the patient (or legal guardian) will be responsible for a $25 missed appointment fee.

Virtual Primary Care Ages 16+

(Includes Urgent Care for All Ages)

+

Behavioral Health Bundle

(Therapy & Psychiatry)

Virtual Primary Care
(Includes Urgent Care)
Behavioral Health
(Therapy & Psychiatry)
PEPM Fee1
(Individual/Family)
VPC Visit Fee2
VPC Utilization
Threshold
Therapy Visit Fee3
Therapy Utilization Threshold
Psychiatry Visit Fee4
$18.00 Individual
$29.00 Family
$25
N/A
$25
N/A
$229 (45-min)
$99 (15-min)

1The PEPM Fee for Individual includes the employee only (i.e. it does not include the employee’s spouse/domestic partner or legally dependent children up to age 26). The PEPM Fee for Family includes one employee and his/her (i) spouse/domestic partner and (ii) legally dependent children up to age 26.

2Virtual Primary Care Ages 16+ (including Urgent Care) visit fees shall be paid in full by patients upfront at the time of service.

3Therapy visits shall be paid in full by patients upfront at the time of service. Therapy sessions are 50-minute, scheduled visits with a Licensed Professional Counselor, Licensed Clinical Social Worker, Marriage and Family Therapy, or equivalent licensed professional; however, the therapist/counselor may determine a 25-minute visit duration is more beneficial for a patient under age 18. The age range for Teen Therapy varies by state and treating provider. For services provided on an appointment basis, if the patient fails to properly cancel a scheduled appointment at least 24 hours in advance of the appointment or if the patient is late to an appointment causing the patient to miss more than 40% of the allotted time for the appointment, the patient (or legal guardian) will be responsible for up to a $65 missed appointment fee.

4Psychiatry visit fees shall be paid in full by patients upfront at the time of service. Psychiatry sessions are 45-minute, scheduled visits for the initial assessment and 15-minute, scheduled visits for medication management with a Psychiatrist, Psychiatric Nurse Practitioner, or Psychiatric Physician Assistant, subject to availability in each state.

Virtual Primary Care
(Includes Urgent Care)
Behavioral Health
(Therapy & Psychiatry)
PEPM Fee1
(Individual/Family)
VPC Visit Fee2
VPC Utilization
Threshold3
Therapy Visit Fee4
Therapy Utilization Threshold5
Psychiatry Visit Fee6
$24.00 Individual
$39.00 Family
$0
100%
$0
20%
$229 (45-min)
$99 (15-min)

1The PEPM Fee for Individual includes the employee only (i.e. it does not include the employee’s spouse/domestic partner or legally dependent children up to age 26). The PEPM Fee for Family includes one employee and his/her (i) spouse/domestic partner and (ii) legally dependent children up to age 26.

2Virtual Primary Care Ages 16+ visits are scheduled and, in addition to virtual routine visits, include one (1) virtual wellness visit per Member per 12-month period. Urgent Care visits are on-demand (i.e. they are not scheduled). For services provided on an appointment basis, if the patient fails to properly cancel a scheduled appointment at least 24 hours in advance of the appointment or if the patient is late to an appointment causing the patient to miss more than 40% of the allotted time for the appointment, the patient (or legal guardian) will be responsible for a $25 missed appointment fee.

3Virtual Primary Care Ages 16+ (including Urgent care) utilization shall be calculated per calendar quarter based on annualized utilization in the aggregate. If the annualized utilization exceeds the threshold, then the PEPM Fee shall automatically, without notice, increase as follows: $1.00 for every 5% of annualized utilization (calculated per calendar quarter) over the threshold (e.g., add $1.00 if annualized utilization is greater than 100% and less than or equal to 105%).

4Therapy visits shall be paid in full by patients upfront at the time of service. Therapy sessions are 50-minute, scheduled visits with a Licensed Professional Counselor, Licensed Clinical Social Worker, Marriage and Family Therapy, or equivalent licensed professional; however, the therapist/counselor may determine a 25-minute visit duration is more beneficial for a patient under age 18. The age range for Teen Therapy varies by state and treating provider. For services provided on an appointment basis, if the patient fails to properly cancel a scheduled appointment at least 24 hours in advance of the appointment or if the patient is late to an appointment causing the patient to miss more than 40% of the allotted time for the appointment, the patient (or legal guardian) will be responsible for up to a $65 missed appointment fee.

5Therapy utilization shall be calculated per calendar quarter based on annualized utilization in the aggregate. If the annualized utilization exceeds the threshold, then the PEPM Fee shall automatically, without notice, increase as follows: $0.05 for every 1% of annualized utilization (calculated per calendar quarter) over the threshold (e.g., add $0.05 if annualized utilization is greater than 20% and less than or equal to 21%.

6Psychiatry visit fees shall be paid in full by patients upfront at the time of service. Psychiatry sessions are 45-minute, scheduled visits for the initial assessment and 15-minute, scheduled visits for medication management with a Psychiatrist, Psychiatric Nurse Practitioner, or Psychiatric Physician Assistant, subject to availability in each state.