Univera Healthcare is excited to announce that we have renewed our partnership with our telemedicine partner, MDLIVE, for Medical and Behavioral Health telemedicine services through 12/31/2028.
As part of our multi-year renewal, the following fee schedule/allowable amount increases are effective 6/1/25. These increases are a direct result of the rising costs and demand for health care, which are having impacts both locally and nationally.
Member Out-of-Pocket Cost Share Impacts
- Non-HDHP Plans: There are no financial out-of-pocket cost share impacts to non-HDHP plans with copay or covered in full telemedicine benefits.
- HDHP Plans: Beginning August 1, members will be financially responsible for full out-of-pocket cost shares due at time of service for visits on or after August 1, 2025.
Common Questions:
Q: Does the cost increase impact group cost share?
A: Yes, group cost share for MDLIVE will increase as a result of this change. While we are covering the balances that members would otherwise owe to MDLIVE, we are not covering the additional costs incurred at the group level.
Q: If a medical plan has a copay or covered in full telemedicine benefit, how does this increase impact enrolled members?
A: Members enrolled in a medical plan with a copay or covered in full telemedicine benefit are not impacted by this increase. Impacted members would be those enrolled in a High Deductible Health Plan (HDHP) when their deductible or coinsurance has not been met yet at time of service.
Q: What happens if a HDHP member used MDLIVE services in the months of June or July 2025?
A: If an HDHP member had a visit in June or July 2025, the cost share will remain the same as it was prior to June 1, 2025. They will not be responsible for the difference between the old and new pricing. Beginning August 1, 2025, HDHP members will need to pay the full new cost share for MDLIVE visits. Members will receive a letter soon so that they are aware of this change.
Q: Why is Univera Healthcare communicating this pricing increase after 6/1/25?
A: Contract negotiations exceeded anticipated projected timelines ultimately impacting communications.
We know that any rate increase places a burden on our members and employer partners. That’s why we continue to partner with the broader health care system to identify opportunities to improve health outcomes and address rising costs. To learn more about our work on affordability, visit our affordability page.
