In recent weeks, the coronavirus pandemic has put new focus on telemedicine as an option for obtaining healthcare services. In the remainder of this blog post we’ll provide an overview of telemedicine, including:
- COVID-19 and telemedicine
- What telemedicine is and how it works
- The pros and cons of telemedicine
- If telemedicine may be a good option for you
- How to get telemedicine
Ready to get a telemedicine plan for you or your family?
Telemedicine and COVID-19
Before we dive into the basics of telemedicine, we’re going to cover some information about telemedicine as it pertains specifically to COVID-19 and the US public health emergency that was declared in March (2020).
Health Savings Accounts and the “No First Dollar Coverage” Rule
Under the Coronavirus Aid, Relief, and Economic Security Act (CARES), high deductible health plans (HDHPs), which are eligible for use with health savings accounts (HSAs), may cover telehealth services and other remote care without cost to the policyholder even before their deductible is met.
Prior to this temporary change, if you had a qualifying HDHP you would have been responsible for all the out-of-pocket costs of the telemedicine services until your deductible was met since telemedicine isn’t considered preventive care.
Telehealth Access Expanded for Medicare Recipients
Prior to the expansion, Medicare enrollees were required to live in a rural area and travel to a local medical facility to obtain telemedicine services from a remote healthcare provider.
However, under the Coronavirus Preparedness and Response Supplemental Appropriations Act (signed March 6, 2020), Medicare beneficiaries can now receive telemedicine services such as office visits, mental health counseling and preventive health screenings from home in order to facilitate the Center for Disease Control’s (CDC) guidance for practicing social distancing.
If you’re a Medicare recipient, whether you need routine healthcare services or have a health concern, contact your healthcare provider or Medicare to find out how to obtain services from home via telemedicine.
What is Telemedicine and How Does it Work?
You’ve probably heard two terms being used with increasing frequency in recent weeks: “telehealth” and “telemedicine.”
Telehealth broadly refers to the “use of digital information and communication technologies, such as computers and mobile devices, to access health care services remotely and manage health care. These could be technologies you use as a patient or that your doctor uses to improve or support the health care services they provide.”
Telemedicine more specifically refers to remote (or virtual) healthcare services you receive via doctor’s appointments.
What that means practically speaking is that you can get screened for a minor routine or recurring health condition by a licensed healthcare provider like a board-certified physician, nurse or physician’s assistant via a video or phone call appointment, receive a treatment plan and even get a prescription sent to your local pharmacy, all without having to leave your home. “Telemedicine” is sometimes also referred to as “telemed” and is not health insurance.
Want to try remote health care? Get telemedicine today.
Telemedicine Pros and Cons
Now that we know what telemedicine is, let’s take a look at the potential benefits and drawbacks of this mode of healthcare.
Possible Benefits of Telemedicine
Convenience – Especially for families with young children or single parents that may find it difficult to get time off of work, juggle other responsibilities and deal with the stress of transporting a sick child and navigate a waiting room. Being able to get an ear infection diagnosis from home may even result in getting treatment started faster.
Out-of-pocket savings – Telemedicine could result in savings if you don’t have health insurance or if you have a policy with more limited coverage.
Telemedicine services, which usually include a monthly subscription fee and per-visit cost, may cost less than a doctor’s office or urgent care visit without insurance.
Average costs of in-person doctor’s office and urgent care visits:
- 30-minute new patient office visit generally costs between $169 and $528 or more.
- Urgent care visit (not including additional tests or diagnostics) generally costs between $149 and $465 or more.
Reduce the spread of contagious diseases – When the phrase “social distancing” became part of normal conversation and stay-at-home orders were issued across most states due to the COVID-19 pandemic, we all became more aware of the risks of contracting and spreading a contagious virus. We became especially aware of the importance of protecting the very old, very young and those that were immunocompromised.
And that’s still important even if we’re talking about the seasonal cold and flu, which are also contagious viruses. Telemedicine may be one way to avoid putting yourself or others at risk by obtaining healthcare from home.
No network restrictions – This can be helpful if you live in a rural area and your closest in-network provider is far away, or even if you’re traveling and wish to speak with a healthcare provider before you return home.
Get expert advice and answers quickly – Many telemedicine services provide access to doctors, nurse practitioners and/or physician’s assistants 24 hours a day, seven days a week, 365 days a year. So even if it’s a holiday or after office hours, you can still get in front of a licensed professional to discuss your health concerns.
Highly accessible – Telemedicine plans are subscription and fee-based and you typically won’t be excluded if you have pre existing conditions. Costs aren’t based on your health status, but instead on factors such as the number of people on your plan, the types of health consultations you opt for and the number of consultations you actually use.
If you’re using telemedicine in conjunction with your health insurance, then prescriptions, referrals and treatment plans that utilize other health providers or pharmacies are subject to your insurance policy’s terms, benefits, and restrictions.
Potential Drawbacks of Telemedicine
For all the potential benefits of telemedicine, there are some limitations to be aware of.
Lack of coordination and continuity of care – Unless you specifically obtain telemedicine services from your primary care provider (PCP) or healthcare facility, your appointment is typically conducted by the next available provider.
That’s why telemedicine, though useful for common but mild health conditions like a sinus infection or skin dermatitis, is not appropriate for managing most chronic or critical health conditions. Ongoing health conditions should ideally be addressed through a single PCP because they’ll have the most knowledge of your health history, and you will be able to follow-up with them if your condition advances or symptoms change.
A false sense of security – Even though it can make healthcare more accessible, a remote consultation is not a substitute for in-person care. It’s important not to downplay or ignore symptoms that persist or worsen after a telemedicine appointment. Remember, remote providers are limited in their ability to assess and diagnose, and you may need to seek further in-person care.
Complex medical histories – Typically, you’ll be asked to manually input your health history prior to your first telemed appointment. It’s unlikely the telemedicine service has access to your existing medical records, so it’s your responsibility to be as complete and accurate as possible.
If you have a complex medical history it can be challenging to remember everything, which may make it harder to engage in productive conversation and obtain an accurate diagnosis. That’s why, as previously mentioned, if you’re managing an ongoing health condition or otherwise have a complicated health history, it may ultimately be safer and more efficient to work with your PCP.
When you need in-person care – Many symptoms require some form of in-person diagnostics like lab tests, a hands-on exam, or imaging to provide an accurate diagnosis. And many conditions require in-person treatment.
Even after obtaining a remote appointment, you may still need to seek in-person care. Find out when you should visit your doctor, the ER, urgent care, or a walk-in provider.
Ready to give it a try? (Remember, Telemedicine is not insurance.)
Is Telemedicine Right for You?
We’ve outlined some of the basic pros and cons of telemedicine, but how do you know if you might benefit from telemedicine? Let’s look at the types of people and situations that may benefit from telemedicine.
The uninsured – Though telemed is neither health insurance nor a substitute for health insurance, if you can’t afford health insurance, telemedicine can provide access to some level of healthcare.
Remember, if you end up needing in-person care or hospitalization, qualifying health coverage like major medical insurance, supplemental hospitalization insurance, or even a limited-benefit (non-ACA) short term health policy could help with some out-of-pocket costs.
Those with narrow network health plans – If your nearest in-network provider is not conveniently located near your home, telemedicine may be an option to help you avoid paying for out-of-network care.
Rural living or lack of transportation – If you live in a remote or rural location and your nearest health facility is far away, or if you lack reliable transportation, telemedicine may help.
Families and single parents – Families with one or more young children, and single parents that need to do it all may benefit from the convenience of telemedicine, especially if a child has a recurring but mild health condition.
As we mentioned before, telemedicine can’t treat everything. Examples of the types of health conditions telemedicine is commonly used to treat include:
- Seasonal allergies
- Acid reflux
- Common cold and flu
- Sinus infection
- Yeast infections
- Pink eye
- Ear infections
- Poison ivy
- Chickenpox and shingles
- Cuts and scrapes
- Bug bites and sunburn
The above list provides examples of conditions that a telehealth provider may treat. Not all providers will be able to treat these conditions and you may be referred for in-person healthcare.
You May Already Have Access to Telemedicine Services
If you have health insurance or employer-sponsored benefits, you may already have access to telemedicine services as part of your benefits.
The only way to know for sure is to contact your health insurance company or your company’s human resources representative, and ask if you have coverage. Another way to find out is to log in to your health insurance consumer portal, where you’ll likely be able to see a list of benefits and services you have access to as part of your plan.
Remember, your current PCP or your preferred healthcare facility may not be who provides the telemedicine services as part of your health insurance. So make sure to weigh the potential convenience of virtual healthcare services with the importance of continuity of care and including your PCP in your health decisions.
If you don’t have access to telemedicine as part of your current health plan or employer benefits package, you can enroll in a plan on your own.
No telemedicine services as part of your current benefits?
Summary + Next Steps
As we’ve seen, there are some distinct benefits and drawbacks of telemedicine. It can be a convenient option for some, but it may not be right for everyone. And you may already have access to telemedicine services.
If you’re considering enrolling in a stand-alone telemedicine plan, it’s relatively easy to get started and to cancel if it doesn’t meet your needs. There’s typically no waiting period before you can start using the service, however, some plans may have waiting periods in certain instances. And many service providers allow you to cancel anytime without long-term subscriptions or contracts.
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