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How does telehealth work?
Telemedicine improves health outcomes and accessibility for remote patients.
At its core, telehealth is a simple way to deliver medical services and share important health information remotely. You can use telehealth services for diagnosing a variety of minor problems, managing chronic conditions and even for preventive care. Although Americans have used telemedicine for years, many insurance companies are expanding services to help members stay safe during the coronavirus.
What's in this guide?
What is telehealth?
Telehealth is a way for patients to get medical care and ongoing health monitoring without going to a physical doctor’s office. For remote doctor’s visits, the consultation might happen over the Internet or by phone.
Outside of consultations, many doctors and medical staff set up technology communications for services like:
- Monitoring. Remote devices can monitor different factors about your health, such as a heart monitor for a cardiac patient.
- Prescriptions. Patients may get common prescriptions after a telehealth doctor’s visit more quickly than if they waited to see their local doctor.
- Information sharing. Doctors can share vital medical information securely through online patient portals to improve outcomes.
- Diagnosis. For minor illnesses or problems, a doctor can sometimes diagnose you and provide treatment recommendations via a video call.
How has telemedicine expanded during the coronavirus?
Insurance companies have expanded telehealth services for both government-backed health insurance and private policies. The services have widened in these ways:
Medicare telehealth expanded
On March 17, 2020, it was announced that Medicare would temporarily pay medical professionals to use these services at the same fee schedule as in-person visits. Telehealth services were also expanded so patients can access more services remotely. Doctors can bill for telehealth with service dates on or after March 6, 2020.
Those under Original Medicare can access specific telehealth services without a copay. Cost-sharing on other plans and for other services may stay in force. Telehealth services without an Original Medicare copay include:
- Common office visits for evaluations or health management
- Mental health counseling
- Online patient portal communication
- Preventive health screenings
Privately insured telehealth services
Although private health insurance companies aren’t required to expand telehealth availability, many are following the government’s example. You may have access to more doctors in-network using telehealth programs and your cost-sharing may get waived, depending on your insurance company.
How does a telemedicine visit work?
To visit with a doctor using telemedicine, you typically access the service through your online patient portal or by downloading a healthcare facility or telehealth app. You should be able to use these benefits with a computer or smartphone. In some cases, your provider might offer a phone hotline.
Follow these steps to use the telemedicine service:
- Download the telemedicine app or follow your provider’s instructions to log into their system.
- Follow the prompts to set up your account.
- You may have to fill out a form for scheduling a visit or requesting a callback.
- Open the portal or app’s video or phone conferencing tool to meet with your provider.
- Explain your symptoms and any health concerns you might have.
- Listen to and write down your provider’s recommendations.
- If needed, your doctor may send a prescription to your local pharmacy. You can pick it up once the prescription is filled.
How can I access telehealth services?
If your health insurance company offers these services, you can video call any eligible doctor, nurse or mental health professional and get coverage. However, cost-sharing may apply based on your Medicare plan, the type of telehealth service or your private insurance company.
Ways you can access telehealth services:
- Health trackers. Wearables, apps and other mobile medical devices can track and send reports to your doctor with personal medical data.
- Real-time video communication. You can interact with health professionals to evaluate your health and make diagnoses based on visual information. Some health insurance may require these to happen using communication tools with both real-time video and audio. In most cases, you can access these tools through your computer, a smartphone or tablet.
- Networked telehealth sites. Health clinics in rural areas can link to larger facilities such as hospitals via high-speed internet. That way patients can visit specialists from the rural hospital facility remotely.
- Online patient portals. Internet portals allow healthcare providers to forward, store and share patient data securely. The patient or relevant providers involved in the patient’s care may get forwarded this information, according to laws from the Health Insurance Portability and Accountability Act (HIPAA).
How to use telehealth through Medicare
In addition, Medicare patients can use telehealth services using these guidelines:
- Virtual check-ins — Must be unrelated to a medical visit from the last seven days and shouldn’t lead to a medical visit within 24 hours. Also, the patient must consent verbally and the doctor should document that consent before using the service.
- Online patient portals — The patient should start the communication with their doctor using this secure online access to their health information.
- Full medical visits — Patients who need specific care but live in rural areas can access medical professionals at specific telehealth locations. The locations are typically nearby medical facilities. Patients should also use a real-time audio and video communication tool for this visit. Under the Medicare Advantage Plan, you might be able to use these services at home.
Which health insurance companies cover telemedicine?
Some health insurers offer coverage or waived cost-sharing for telehealth services during the coronavirus. Checked as of April 1, 2020, learn what telehealth benefits these companies are offering:
|Insurance company||Telehealth benefits offered|
|Aetna||No copay for telemedicine visits for any reason. Is expanding its Medicare Advantage evaluation visits to all fully insured members.|
|Anthem||Is waiving cost-sharing for telemedicine visits for 90 days starting March 17, 2020, including mental health visits. Medicare, individual and employer-insured plans can access this benefit. Anthem encourages all members to use telemedicine whenever possible.|
|Blue Cross Blue Shield Association||BCBS and all its independently operated companies are expanding telehealth networks and phone provider hotlines. They’re also waiving telehealth cost-sharing for fully-insured members for 90 days, starting March 19, 2020.|
|Centene||Is expanding access to its telehealth services and waiving cost-sharing for coronavirus-related telehealth visits.|
|Cigna||Cigna is waiving member costs for coronavirus-related telehealth visits and making telehealth services more accessible to at-risk patients or those with limited transportation. These benefits apply through May 31, 2020.|
Cigna has also set up a 24-hour toll-free hotline to connect members to qualified providers: 866-912-1687.
|HCSC Corporation||If your current plan covers telemedicine visits, you can access these services without cost-sharing.|
Services you might have access to include live video calls with a doctor, mail-order prescriptions and 24/7 access to a nurse hotline. The nurse’s hotline number is 800-581-0368.
|Humana||Is waiving cost-sharing for urgent care telemedicine visits for Medicare Advantage, Medicaid and employer-sponsored plans. The benefit extends for the next 90 days, starting March 6, 2020.|
Members can also call the customer support line for questions and concerns about the coronavirus, including live telemedicine support. The toll-free phone number is listed on the member ID card.
|Kaiser Permanente||Is extending telemedicine visits by video or phone calls when appropriate. Also encourages members to use its mail-order pharmacy for prescriptions.|
|Molina Healthcare Inc. Group||Molina offers Medicaid members over age 19 no-cost access to telemedicine visits through Teledoc. The company also offers a chatbot feature to assess your coronavirus risk.|
|UnitedHealthcare||United is waiving members’ costs for coronavirus-related telehealth visits. It’s also expanding access to its telehealth network.|
What specialists use telehealth?
Depending on the type of treatment you need, you may have access to:
- Telemedicine. Live video conferencing and information sharing between healthcare professionals and patients in remote locations.
- Teleradiology. Teleradiology allows general doctors to send X-rays securely to a radiologist at another location to speed up diagnosis for a patient’s condition.
- Telepsychiatry. Telepsychiatry lets psychiatrists treat patients remotely, increasing public access to behavioral health services.
- Teledermatology. Teledermatology allows doctors to send pictures of patients’ skin conditions to a skin specialist.
- Teleophthalmology. With teleophthalmology, ophthalmologists can examine a patient’s eyes remotely to diagnose eye problems.
- Telenephrology. Telenephrology allows a general medical practitioner to consult a nephrologist virtually about a patient’s kidney problem.
- Teleobstetrics. Teleobstetrics enables an obstetrician to provide remote prenatal care for some routine visits.
- Teleoncology. With the aid of teleoncology, oncologists can provide more accessible and convenient care to patients with cancer.
- Telepathology. This technology allows pathologists to share high-resolution images and videos for diagnosis, research and education.
- Telerehabilitation. Allows medical professionals to provide some physical therapy services remotely.
Telehealth has gained ground recently with expanded services for urgent care, common health checkups and accessing specialist opinions for smaller health clinics. Its services can help patients stay home while still accessing the healthcare they need.
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