Coronavirus forced the world to change how it does business in record time.
Stay at home orders across the U.S. have entire industries of employees working from home, only venturing out to obtain necessities.
The virus changed not just the way people work and spend their free time, but it has also changed the face of the healthcare industry.
Due to its contagious nature, millions of people were recently forced to put off necessary medical treatments and avoid medical facilities. These events will have a lasting effect on how healthcare is delivered worldwide.
Perhaps the largest change already taking place is the acceptance of virtual or online medical care and the willingness of medical professionals to provide it. Right now, more patients have access to virtual visits than ever, and with many insurance companies, it is covered completely.
Commercial and Private Insurance Coverage for Telemedicine
Commercial insurers like Aetna, Blue Cross Blue Shield, United Healthcare, etc. have already implemented telemedicine as an alternative to in-person medical visits. There’s no set standard for private health insurance but most insurance carriers are encouraging patients to use telehealth whenever possible. Telemedicine coverage details will depend on which plan you chose but generally, they’ve improved coverage for these in order to make virtual care widely accessible.
The expanded coverage may not only help to prevent the spread of COVID-19 and other viruses and bacteria but may also lower costs for both patients and insurers. These steps may also pave the way for further advances in telemedicine, including a reduction or elimination of deductibles and co-pays for patients associated with telemedicine and an increase of in-network providers. The changes ultimately make it easier and more convenient for people to utilize virtual healthcare services and the notion of seeing a doctor or medical professional from the comfort of your home will likely become quite mainstream in the years ahead.
For details about specific insurance companies’ telemedicine coverage during COVID-19, visit America’s Health Insurance Plans Association (AHIP’s) here and review their database of policy responses.
Telemedicine Coverage with Medicare and Medicaid
Medicare and Medicaid also put into effect similar telemedicine coverage changes. At the federal level, the Department of Health and Human Services drastically loosened restrictions for online medical care as the need for care without the risk of infections rose. Actions already taken include waived enforcement of some HIPAA regulations for telemedicine. This allows providers and patients more options regarding the types of videoconferencing tools they can use. Apps and software that are more readily available and accepted (Zoom, Skype, FaceTime, etc.) can now be used. Additionally, a reduction in restrictions by the Drug Enforcement Agency on electronic drug prescriptions was approved. Medicare and Medicaid patients are now allowed to obtain online health care from any location more easily and with more options for delivery.
As of this writing, Medicare beneficiaries’ telehealth visits will be covered just like an in-person office visit. Medicaid is different in that it is administered by each state versus at the federal level. Review a state-by-state interactive overview of telehealth coverage here from the Center for Connected Health Policy.
How to Verify Your Coverage
The best way to verify online treatment availability and coverage is to simply ask. Insurers provide toll-free phone numbers for patients to call and inquire about services. States and the federal government also provide assistance via the telephone to those participating in Medicare or Medicaid. In order to verify whether your treatment or appointment may be covered, you will need some key information like your provider’s name, the reason for the treatment or appointment, and the name of your specific insurance plan and group number.
When you speak to someone by phone, it is also a good idea to get your coverage details in writing. This may simply be a paragraph in your policy that outlines coverage for the desired treatment or appointment and discusses how or if it will be covered by the policy. Staff at SCHC can also help you confirm coverage before scheduling treatment or an appointment.
What Health Services Can Be Delivered Through Telemedicine?
While not all providers will cover the same things, most doctor-patient consultations can now be virtual. Counseling, therapy, and psychotherapy visits are another area easily provided virtually. Unless testing is required, there is really no limit on the types of appointments that can be completed from the comfort of your home. Examples include headaches, stomach aches, allergies, sore throat, flu-like symptoms, even injuries, can all potentially be managed with your medical provider by phone or video conference. You don’t need to postpone basic healthcare. SCHC wants you to stay as healthy as possible so whether it’s an injury or a persistent symptom get the medical attention you need, without leaving your home or in-person, you decide.
Insurers, governments, and patients have all been forced to adapt to some rapid and significant changes in healthcare over the last few months. As a result, some aspects of telemedicine delivery may take more time to fine-tune the remaining challenges. Gaps in technology needed to connect to telemedicine may be a hurdle for some patients. Privacy concerns may also become increasingly challenging to deal with and how these services are billed and paid for by insurance companies is also likely to become an area of focus.
As the spread of COVID-19 continues, the availability of online healthcare is likely to increase. “Going to the doctor” may not be going to the doctor at all anymore, as more and more people take advantage of these newly covered services. The world of global healthcare is changing quickly. It may be too early to tell what stays and what goes, however, the need for telemedicine is clear.