If You’re Not Using Telehealth, Here’s Why Your Next Visit Should Be Virtual
Written by: Andrew Hall
Telehealth and telemedicine often are used interchangeably, but they are not the same.
Telehealth is a convenient option to manage your health and access your provider from home for routine care and consultations.
Medicare Part B covers telehealth services and consultations. You may be responsible for 20% copay and any Part B premium .
Telehealth delivers digital healthcare to your mobile device. Telehealth is virtual care that includes doctors, resources, and near real-time communication. Telehealth provides convenient access to care when and where you need it.
Telehealth is an excellent option for virtual routine provider consultations. Virtual care is not a replacement for specific preventive care, lab work, and screenings.
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There are three main types of telehealth services:
- Telemedicine visits are a secure two-way video visit to replace an in-person office visit. An appointment can include doctors, nurse practitioners, clinical psychologists, and other care providers.
- Virtual check-ins are typically a brief video or telephone conversation to decide if you need an in-person visit. These visits are for existing patient and provider relationships.
- E-visits are secure and near real-time online communications with your doctor. E-visits are a useful way to receive direct reply answers from your provider without a visit.
Telemedicine is one type of telehealth that provides clinical services using video technology. You can use a mobile device or laptop with video and audio capabilities to replace an in-person appointment. Virtual visits are secure and convenient and provide access to care for a broad range of needs, including:
- A check-in to manage a chronic disease or health goals
- Mental health counseling with a psychologist
- To diagnose something topical on a patient like a skin rash
A doctor can use telemedicine for some diagnoses, but they cannot touch an injury and are limited to what they can see on the screen. If you need tests or lab work, you must schedule an in-person visit.
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If you’re over 65 with health complications, you are at high-risk for contracting the COVID-19 virus. During this time, proactively managing your health from home with telehealth tools can reduce your risk of exposure to the virus.
Medicare’s decision to expand telehealth coverage during the pandemic resulted in a boom of telehealth usage that’s projected to become even more widespread. [i]
Medicare Coverage for Telehealth During COVID-19
At the start of the COVID-19 public health emergency, the Centers for Medicare and Medicaid Services (CMS) expanded telehealth services for Medicare beneficiaries. Previously, beneficiaries had to live in a rural area and access the service from a designated healthcare facility. Telehealth expansion allows beneficiaries to use telehealth from anywhere, including in their own homes, for non-emergency visits.
Some Medicare plans allow beneficiaries to see their regular providers by video during COVID-19. Others have a separate network of providers for scheduling appointments. Medicare pays the same rate for Telehealth visits as in-person visits, so coinsurance and deductibles can apply. In some cases, your provider may reduce or waive the out-of-pocket costs altogether for telemedicine visits during the pandemic.
Medicare Advantage plans may offer more telehealth benefits than Original Medicare. A licensed GoHealth agent can take time to help you understand the options for your specific plan.
A Breakdown of Medicare Coverage
Part B covers services to treat and diagnose medical conditions. Virtual visits are an easy way to access Preventive services, and Part B covers them. Your Part A coverage primarily covers inpatient hospital care and is less likely to use virtual services.
Medicare Advantage (Part C) plans are offered by private insurance companies that work alongside Medicare Part A and Part B. Usually include Part D. Your access to virtual visits and telehealth services is the same as Original Medicare. Also, you can manage prescriptions virtually if your Medicare Advantage plan includes Part D.
Medicare Prescription Drug Plan
Part D is a Medicare prescription drug plan separate from Original Medicare. Original Medicare only provides coverage for prescription drugs while in a hospital, so many people choose to add a Part D plan to help cover the costs of every day prescription drugs. Medicare Advantage plans usually include Part D. If you have Part D alongside Part A and Part B, you will be able to manage prescription drug needs with virtual visits and telehealth tools.
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You might worry about privacy and security for a telemedicine visit. The Health Insurance Portability and Accountability Act (HIPAA) protects all Telehealth patient information. When you take the right steps to prepare, you can rest easy that your visit is safe and secure.
Use your Wi-Fi network to connect to your computer or phone, if possible, rather than a shared or public device. The healthcare industry has made significant advances in virtual technology and tools over the past few years. Concern about virtual care being less safe as a doctor visit is a common misconception.
You may not be ready to give up your office visit, but that doesn’t mean you can’t use technology to stay connected to your doctor. Telehealth manages data transmitted from devices like an Apple Watch or FitBit. Your provider can monitor your vitals and activities like exercise, heart rate, and blood pressure. If any of your numbers are unusual, your provider can contact you with possible interventions.
A voice-activated bot like Alexa can also help you improve your health. Voice skills can answer nutrition questions, even make suggestions for a healthy diet.
Providers and healthcare systems are quick to adopt telehealth services. Patients can save time by eliminating travel, and keep themselves and others safe during the pandemic. Congress and Medicare agree that more access to telehealth will benefit patient populations, but recognize it’s not a catch-all solution. If you have a medical emergency, go to the emergency room or call 911.
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A licensed GoHealth Telecare agent can walk through your plan with you and determine what is covered and what you will have to pay out of pocket.
A working laptop or smartphone with a camera and microphone allows your doctor to see and hear their best during the appointment. You need a secure Wi-Fi connection or cable internet if you are not using cellular data.
In most places across the U.S., doctors’ offices are reopening for preventive visits and elective procedures. Contact your doctors’ office or health plan for more information on new rules and measures to keep everyone safe.