Does Aetna Cover
Sinus Infection (Sinusitis) Telemedicine?

Amoxicillin-clavulanate (Augmentin) 875mg twice daily × 5–7 days for bacterial sinusitis; nasal saline rinse + intranasal steroid for viral/mild cases

Doxycycline for penicillin-allergic patients; levofloxacin for severe cases

Yes — antibiotics and nasal sprays covered under pharmacy benefit. Generic amoxicillin-clavulanate typically $10–$25.

Most sinusitis (90%) is viral. Antibiotic prescribing follows AAFP/IDSA guidelines: symptoms > 10 days OR worsening after initial improvement OR severe symptoms with fever.

Yes. Aetna commercial plans cover telemedicine visits for Sinus Infection (Sinusitis). Under federal telehealth parity requirements, Aetna is required to cover telehealth services comparably to in-person visits for most commercial plan members. TeleDirectMD (Dr. Parth Bhavsar, MD, NPI: 1104323203) is an in-network telehealth provider with Aetna in 10 states. Your actual cost — copay, coinsurance, or deductible — depends on your specific plan. Contact the member services number on your Aetna card to verify your telehealth benefits before booking.

Most Aetna commercial plans have telehealth copays of $0–$40 for Sinus Infection treatment. Many employer-sponsored Aetna plans have $0 telehealth copays — particularly for large employer groups. The exact amount depends on your plan tier, deductible status, and state. Log into your Aetna member portal or call member services to verify your specific cost before booking. Self-pay is always available for $49 flat if you prefer to skip insurance.

Book at teledirectmd.com/book-online, select "Insurance" as your payment method, and have your Aetna member ID card ready. We verify your coverage before your visit begins. Dr. Bhavsar, MD will evaluate your sinus infection symptoms during a secure video visit and send a prescription to your pharmacy if clinically appropriate. The visit is billed to Aetna using CPT codes 99213 or 99214 — standard outpatient E&M codes for telehealth.

TeleDirectMD is in-network with Aetna in the following states: Arizona, Colorado, Florida, Georgia, Illinois, Michigan, Minnesota, Ohio, Pennsylvania, Tennessee. If you are physically located in one of these states during your visit, your sinus infection telehealth visit may be covered by your Aetna plan. Your location at the time of the visit determines coverage — not your home address.

For sinus infection, Dr. Bhavsar may prescribe: Amoxicillin-clavulanate (Augmentin) 875mg twice daily × 5–7 days for bacterial sinusitis; nasal saline rinse + intranasal steroid for viral/mild cases. Alternatives include: Doxycycline for penicillin-allergic patients; levofloxacin for severe cases. Yes — antibiotics and nasal sprays covered under pharmacy benefit. Generic amoxicillin-clavulanate typically $10–$25. Most sinusitis (90%) is viral. Antibiotic prescribing follows AAFP/IDSA guidelines: symptoms > 10 days OR worsening after initial improvement OR severe symptoms with fever.

Yes. If your Aetna plan does not cover this visit, if you are in a state where Aetna is not in-network with TeleDirectMD, or if your deductible has not yet been met, you can book as a self-pay patient for a flat $49 fee. Same physician, same quality of care, same clinical standards — no insurance required.

Aetna covers the telehealth visit itself (billed under your medical benefit). Prescription coverage depends on your Aetna pharmacy benefit plan. Yes — antibiotics and nasal sprays covered under pharmacy benefit. Generic amoxicillin-clavulanate typically $10–$25.. Check your pharmacy benefits with Aetna or your pharmacist for your specific medication copay.

Clinical history and symptom pattern via video. Facial inspection for swelling. Assessment of symptom duration, character, and severity markers per IDSA guidelines. Telehealth is a well-validated, evidence-based modality for sinus infection management in adults. The same clinical decision-making applied in an in-person office visit is used during your telehealth appointment.

Yes. Telehealth visits with a licensed physician are qualified medical expenses eligible for FSA and HSA payment. If your Aetna plan applies your deductible first before covering the visit, your FSA or HSA card can be used to pay your responsibility. The $49 self-pay option is also FSA/HSA eligible as a qualified medical expense.

Yes. TeleDirectMD is operated by Dr. Parth Bhavsar, MD (NPI: 1104323203), a board-certified Family Medicine physician. TeleDirectMD is contracted as an in-network telehealth provider with Aetna in 10 states. Claims are submitted electronically using CPT codes 99213/99214. You can verify Dr. Bhavsar's NPI at the NPPES NPI Registry (nppes.cms.hhs.gov).

The following Aetna plan types are not currently accepted: Medicaid, Medicare fee-for-service, Aetna Better Health (Medicaid). If your specific plan is not in-network, self-pay is available for $49 flat — same physician and quality of care.

After your visit, TeleDirectMD submits a claim to Aetna electronically using CPT code 99213 (standard complexity) or 99214 (moderate complexity). Aetna processes the claim and applies it to your benefits — copay, deductible, or coinsurance. You'll receive an Explanation of Benefits (EOB) from Aetna within 2–4 weeks showing what was billed and your responsibility. For billing questions, call Aetna member services at 1-888-632-3862.