telemedicine

Does Insurance Cover Telemedicine Costs?

One of the ways COVID has changed our system is the large increase in telehealth meetings and clients often ask “does insurance cover telemedicine costs?”  Over the past year, telemedicine insurance coverage has evolved.  While telehealth is not a new practice, it has become much more widely utilized since the outbreak of Corona virus.  Historically, telemedicine was utilized in certain instances, such as for patients who lived in remote areas with limited access to doctors and other resources.  In regard to telehealth insurance coverage, effective March 2020, Medicare began covering these visits under much broader guidelines and were paid at the same rate as in-person visits.  Some of the most common technology platforms include FaceTime, Zoom, Google Hangouts, and Skype.  Under the guidelines during the pandemic, the use of two-way audio-only communication has also been permitted.  The use of these platforms has allowed physicians to screen their patients, recommend and treat the issue at hand, and follow-up accordingly, all while minimizing the risk of exposure to COVID.

It is safe to assume that the use of telehealth will continue following the pandemic and getting answers about does insurance cover telehealth will continue to be important. 

Prior to COVID, it was estimated telehealth accounted for $3 billion of what Medicare, Medicaid, and commercial insurers spent on outpatient office and home health visits.  That number is expected to rise to about $250 billion post-COVID.

Of course, with the increased of telemedicine use comes expected and unexpected challenges. 

With telehealth insurance, some limitations that have been considered when it comes to increasing its use include the licensure issues that may vary state-to-state, occasions when it is more appropriate to physically screen a patient, limited access to technology or connection issues, and the patient(s) comfort level with using technology and/or while discussing more sensitive topics.

Over the last year, our care coordination team has adopted Zoom as the way to conduct our initial appointments, estate planning design meetings, and other meetings with clients.  Despite “connecting” virtually, we miss that personal connection and the opportunity to figuratively and literally “hold our client’s hands” during difficult times.  We look forward to being able to re-open the office to in-person visits when vaccinations become widely available.

If you want more information concerning does insurance cover telemedicine and have computer access, log into Medicare.gov to see if your test or procedure is covered.  It is always safe to stick to official websites such as this one to find more information.   

Here are some of the benefits you can access through Medicare.gov:

  • You may be able to communicate with your doctors or certain other practitioners without necessarily going to the doctor’s office in person for a full visit. Medicare pays for “virtual check-ins”—brief, virtual services with your physician or certain practitioners where the communication isn’t related to a medical visit within the previous 7 days and doesn’t lead to a medical visit within the next 24 hours (or soonest appointment available).
  • You need to consent verbally to using virtual check-ins and your doctor must document that consent in your medical record before you use this service. You pay your usual Medicare coinsurance and deductible for these services.
  • Medicare also pays for you to communicate with your doctors using online patient portals without going to the doctor’s office. Like the virtual check-ins, you must initiate these individual communications.
  • Since some people don’t have access to interactive audio-video technology needed for Medicare telehealth services, or choose not to use it even if offered by their practitioner, Medicare is allowing people to use an audio-only phone.
  • You may use communication technology to have full visits with your doctors. Also, you can get these visits at rural health clinics and federally qualified health clinics. Medicare pays for many medical visits through this telehealth benefit.

Feel free to explore our website. As always, if you have a more complicated situation or question, call our office at 239-434-8557 to set up a free telephone conference to see if we can help you.

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