During these uncertain times, it can be very nerve-wracking not knowing if you can receive care if you need it. Many private practices are closed, but still offering care via the phone, computer and other virtual options.
If you have Medicare, the good news is that Medicare has expanded its coverage to include telehealth services. Many other insurance companies have followed suit as well.
What Are Telehealth Services?
Simply put, telehealth is any long-distance health care, both clinical and non-clinic. This includes a variety of virtual services:
- Email communication through patient portals
- Online chat
- Phone appointments
- Video appointments
Medicare and Telehealth Services
Here are the guidelines for using telehealth services through Medicare:
Medicare has temporarily expanded its coverage of telehealth services to respond to the current Public Health Emergency. These services expand the current telehealth covered services, to help you have access from more places (including your home), with a wider range of communication tools (including smartphones), to interact with a range of providers (such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social worker). During this time, you will be able to receive a specific set of services through telehealth including evaluation and management visits (common office visits), mental health counseling and preventive health screenings without a copayment if you have Original Medicare. This will help ensure you are able to visit with your doctor from your home, without having to go to a doctor’s office or hospital, which puts you and others at risk of exposure to COVID-19.
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.
If you live in a rural area, you may use communication technology to have full visits with your doctors. The law requires that these visits take place at specified sites of service, known as telehealthoriginating sites, and get services using a real-time audio and video communication system at the site to communicate with a remotely located doctor or certain other types of practitioners. Medicare pays for many medical visits through this telehealth benefit.
Medicare Advantage Plans and Telehealth Services
If you have a Medicare Advantage plan or supplemental Medicare, you’ll have to contact your insurance provider directly to see what telehealth services are covered. Many of the insurance carriers offer some telehealth services for specific information or clarification contact Twin City Underwiters or call the number on the back of your card.
During this time, do not neglect any health concerns you have – it’s important to use telehealth services if you need them. If you have any questions about telehealth or your coverage, contact Twin City Underwiters.