Telemedicine provides quality health care in your home
By Kathleen Harte Simone
Imagine this: You meet with your doctor from the convenience of your smartphone or personal computer, pay no additional costs, and, as always, leave the claim filing to the health care provider. It’s called telemedicine. It’s how millions of Americans of all ages have been receiving quality health care since the onset of the COVID-19 pandemic.
Changed perceptions of telemedicine
“Members are responding favorably to the safety, convenience and [quality of] medical care they are receiving with telemedicine; perceptions have really changed,” said Justin Davis, president and CEO of PA Health & Wellness. “This means our members can get medical advice, a prescription and, in some cases, a diagnosis by video or phone. We want to make sure all of our members are aware of this service so they can still have access to high-quality care while in their home.”
A March 2021 Sykes marketing research survey showed that 61.5% of all Americans have received telemedicine care in the last year. That’s a vast increase over the 19.5% that used telemedicine in the prior year. The older adult community has embraced this change. Americans 65 and older have scheduled more telemedicine appointments than any other age group, according to a survey used by the National Center for Health Services.
Now that connecting with a doctor – whether it be a primary care physician or specialist – is easier than ever, why are some older adults still reluctant to try telemedicine?
“For older adults who do not use telemedicine, it can be because they are unsure which services are covered by their insurance, and how much is covered,” said Marie Strasser, a Philadelphia-area independent insurance agent. “We need to continue to educate [older adults] on this so that every patient can get the care they need from the comfort of their home or homecare facility, if they choose.”
What medical services are provided with telemedicine?
According to the U.S. Centers for Medicare and Medicaid Services’ Medicare. gov website, you can use telehealth services for medically reasonable services, including virtual appointments with doctors, nurse practitioners, clinical psychologists, physical and occupational therapists, and licensed clinical social workers. Preventive services are also covered through telemedicine, including depression screenings, diabetes self-management training, medical nutrition therapy, and intensive behavioral therapy for cardiovascular disease or obesity. And, telemedicine coverage extends to providers you’ve never seen before, both in and out of your home state.
Although telehealth services typically require both audio and video technology, you can use only the audio on your phone for certain evaluation and management services, such as periodic assessments and counseling sessions.
An expansion of telemedicine coverage was enacted with the Medicare and Medicaid 1135 Waiver, effective March 2020, in response to COVID-19 public health emergency declaration. Prior to this waiver, telemedicine was approved for only a very small segment of the rural population with limited access to health care.
What telemedicine services does Medicare cover?
Your Medicare benefits will be the same whether you see a doctor in person or through telemedicine. This applies whether you are at home or at a health care facility. This provision will apply for the duration of the COVID-19 Public Health Emergency, as specified by the federal government.
Keep in mind, you will still pay 20% of the Medicare-approved amount for your health care provider’s services, and the Part B deductible applies. But there is good news: the Health and Human Services Department gives health care providers the option to reduce or waive cost-sharing for telemedicine visits. At least one major insurance company is waiving copays, deductibles and coinsurance for in-network medical or behavioral health telemedicine visits for Medicare Advantage beneficiaries until the end of December 2021.
Are there any Medicare telemedicine benefit exclusions?
At this time, you can rest assured that your Medicare benefits will be the same if you see your doctor in-person or with the help of your computer or phone. Exceptions, which are outlined in every health insurance policy, generally are visits that absolutely require a patient to be in person, such as transfusions and dialysis. Though rare, some plans may also restrict the doctors you can see. When making your appointment, be sure to verify that telemedicine services are covered. If you have any questions about your insurance coverage, contact your provider directly.
These days, it’s easier than ever to see your primary doctor or a specialist with the added benefit of telemedicine. The bonus of no additional cost or paperwork for you makes being well even brighter.
For more information about Medicare and covered services, go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
Kathleen Harte Simone is a Philadelphia-based journalist.