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Some Patients Charged Copays for Sending Messages Through Patient Portals

Medically reviewed by Carmen Pope, BPharm. Last updated on April 11, 2025.

By Lori Solomon HealthDay Reporter

FRIDAY, April 11, 2025 -- People covered by Medicaid are just as likely as those with private insurance to face a copay or other charge for sending a message to their physician or other provider through a portal, according to a research letter published online April 4 in JAMA Health Forum.

Terrence Liu, M.D., from the University of Michigan in Ann Arbor, and colleagues assessed the prevalence of reported copays for portal messages by health insurance type among U.S. adults (aged 50 years and older) who used portal messaging. The analysis included 3,212 survey respondents.

The researchers found that 76.2 percent of respondents reported having a patient portal and 64.7 percent reported sending a portal message in the past year. The range for older adults having sent a portal message in the past year was 58.6 percent for those with traditional Medicare without supplemental insurance to 75.2 percent with Veterans Affairs coverage. Few respondents (13.1 percent) reported being charged a copay for sending a portal message, with the highest estimate of 16.6 percent for those privately insured and 15.9 percent for those dual-eligible or with Medicaid.

“Even though we don’t know the exact dollar value of the charges these older adults paid, our findings raise questions about making sure out-of-pocket costs are not keeping vulnerable populations from using a potentially helpful technology,” said Liu said in a statement. “As policymakers consider the long-term future of the telehealth rules that made it possible for providers to bill for patient portal messaging, we hope our findings inform policy that considers the needs of financially vulnerable populations.”

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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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