What Is Telehealth & Is It Covered by Insurance?

The COVID-19 global pandemic changed the course of our lives in so many dimensions. With countries worldwide under complete lockdown, we were forced indoors and relied on technology to get through those dark and bleak days.

This was when we truly learned to value our health, and it was also a time when our lives depended on quality healthcare. Therefore, many people turned to telehealth – and they still do. Online doctor visits are becoming popular for those wishing to access healthcare from their houses. And the best part? All you need is a smartphone or computer, and you can gain access to telehealth, also sometimes known as telemedicine.

And this brings up the question:

What Is Telehealth?

Telehealth is the use of digital communication to access healthcare services remotely. It’s a service whereby we can use video calling and other technologies to consult a doctor or a healthcare provider from your home rather than at a medical facility. While telehealth reached its peak amidst the COVID-19 pandemic, its benefits and conveniences have made people embrace this technology for years to come.

It’s particularly beneficial for older adults who are limited in their mobility and for those who live in rural areas where they won’t be able to access good doctors. Talking to your doctor through an electronic device is quicker, easier, and less expensive than making a long trip to the doctor’s office.

Pros of Telehealth

Telehealth brings along with it a host of benefits, one of which is that it allows patients and providers to connect in a better way. This, in turn, enhances the level of care, and since this service is easily accessible, it benefits communities as a whole.

Since you can consult doctors remotely, there are no transportation costs, and you can save time that you would otherwise have to spend aimlessly in the waiting room. Besides, you are more susceptible to catching more infections when sick, so telehealth exponentially lessens the chance of contracting a new illness. It also offers better access to specialists.

Limitations of Telehealth

Where there are great benefits, there are also some drawbacks. There is no doubt that telehealth has great potential to offer well-coordinated care. Still, there is also a healthcare gap, given that doctors cannot perform a physical examination, which can adversely affect the diagnosis.

While telehealth allows you to consult doctors remotely, only some visits can be done this way. For example, you will still need to be present physically to get imaging tests and blood work. Moreover, since telehealth uses technology, the security of personal health data transmitted electronically can be a concern.

Another drawback is that it’s difficult for the patient and doctor to build rapport. Many people generally expect a more personal experience when consulting a doctor, and conversing digitally can limit interactions.

Preparing Yourself for a Virtual Doctor’s Visit

There is no need to be intimidated by technology – it’s so much easier than you think. Here’s how you can prepare yourself for a virtual doctor’s visit:

  • Your healthcare provider should be able to see and hear you well, so ensure your phone or computer has a good microphone and clear camera. Check your equipment in advance and charge it before the appointment.
  • Allow access to your camera and microphone. Having strong security settings can often hinder your telehealth appointment.
  • Since telemedicine portals need strong processing power, you need a stable connection so your call isn’t dropped midway through the appointment. Ensure your device is set up where the signal is the strongest, and close any other applications you don’t need.
  • You cannot and should not hide anything from your doctor because they need honest answers to provide the correct diagnosis. Sometimes, you may even have to talk about personal issues, so ensure that your privacy is protected by setting up your device where you can speak freely.

Are Telehealth Appointments Covered by Insurance?

Many health insurance companies, both public and private, will cover at least some form of telehealth. During the COVID-19 lockdown, many healthcare providers resorted to telehealth visits to connect with their patients, and the benefits this technology brought in its wake are indisputable. Therefore, some states took action and mandated that insurance companies should cover those types of healthcare too. Some rules regarding telehealth coverage have since remained in place even today.

As we know, insurance coverage is often complicated, and since each policy is different, the range isn’t always as straightforward. It’s not easy to make a general statement about how each one works, but as a whole, most insurance plans should at least have some form of telehealth coverage. This varies from state to state, so it would be a good idea to check with your insurance providers for the latest information about telehealth coverage.

Does Medicare Cover Telehealth Appointments?

Specific requirements should be met for Medicare to pay for your telehealth services. But Medicare expanded healthcare coverage to all enrollees due to the COVID-19 pandemic. Therefore, they will likely pay for telehealth services, including provider visits, mental health consultations, and psychotherapy. However, you should pay for your Medicare Part B deductible and about 20% coinsurance to gain access to these services.

Does Medicaid Cover Telehealth Appointments?

Since Medicaid is a state-based program, the plan covered will vary by state. As per federal rules, each state can determine whether they wish to cover telehealth for its members. On top of this, they can also decide how providers are reimbursed and even set limitations on the types of telemedicine care.

Do Private Healthcare Companies Cover Telehealth Appointments?

Over 40 states require private insurance companies to cover telemedicine services. If you live in any of those states, then your telehealth appointments will most likely be covered in the plan.

Insurance companies provide identification cards, paperwork, and other documents upon enrollment. The paperwork will have a phone number you can dial for member services. Call that number and inquire about telehealth and the coverage they offer. Sometimes, your insurance company might cover telehealth even if the state doesn’t require it, so calling would be the best way to ensure that you have telehealth coverage.

Bottom Line

We live in an era of rapid technological advances, which has paved the way for telehealth to stand at the forefront of healthcare. It’s easy, fast, and convenient, which might make you wonder if it comes with a high price tag. Cost is generally a matter of concern regarding healthcare, and knowing that your health insurance covers telehealth can give you peace of mind.