Charged for an email? It’s happening to patients who are asking about new symptoms

October 2, 2023

Today many of us email our doctor when we have questions or new health symptoms. Isn’t technology making our lives better? Yes and no. Now some doctors and health systems are charging for those convenient emails as “e-visits.”

The trend took off during the pandemic, when more and more people emailed their doctors with concerns. Now, medical institutions including the Cleveland Clinic and Mayo Clinic are billing patients for those emails in order to compensate doctors for their time, and to encourage people to come into the office in person when necessary. University of California San Francisco started charging in November of 2021 and patient messaging went down.  Hospitals like Providence also charge for email communications.

Typically, the e-visit charges apply to emails that take more than five minutes of a physician’s time and involve some medical expertise. That can include questions about medication changes, new symptoms and even long-term condition updates.

At least for now, scheduling and prescription refills aren’t being treated like e-visits, and patients aren’t charged for those.

However, there is concern about the unintended consequences. Patients may hesitate to seek medical advice via email, fearing the added costs, and this could particularly affect those with chronic illnesses. It could also financially impact lower-income individuals who rely on email consultations. And there’s concern about price transparency since many patients don’t know when or how much they’ll be charged for an email.

Take Meg Bakewell for example. She has cancer and cancer-related heart disease, and she sometimes emails her physicians asking for advice about symptoms. She was surprised when she got a $13 copay for an email interaction with her primary care doctor. Now she’s concerned her emails may all add up. “It’s the vagueness of the whole thing. You don’t know if you’ll get into a copay or not. It just makes me hesitate,” she said.

Some health systems are trying to find a middle ground and experimenting with other solutions like using chatbots to draft email replies.

Have you been charged for an email with your doctor? Share your story here.