Does Medicare Cover Telehealth Services?

It’s not always easy or even possible to see your doctor. This is especially true for the millions of seniors in the United States who are homebound. Despite this, health care is essential to maintaining a happy and healthy life. Is there a solution for people struggling to see their doctor, but still in need of health care?

With the rise of the internet, health care at home is more accessible. This isn’t plugging your symptoms into WebMD and calling it a day. As technology becomes more sophisticated, the ability of medical professionals to meet their patients’ needs grows exponentially. Enter telehealth, bringing health care to your doorstep.

What is Telehealth?

Telehealth is the use of electronic information and telecommunications to support long-distance health care. For many, these technologies are used by the patient in their own home or at a specialized location. This isn’t the only use, however. Telehealth can also refer to technologies used by your doctor to improve a patient’s health care.

For patients, telehealth, also called e-health, can be accessed by using a specialized app on a your phone or computer to access a patient portal to view test results or report medication doses. Significantly, patients can even use telehealth to communicate with their doctor virtually and get prescriptions if necessary. In many senses, it’s the same as an in-person appointment, only held over video chat.

For Medicare plan holders, many e-health services are covered the same as in-person visits. Generally speaking, Medicare Part B will cover live telehealth and telemedicine services that are comparable to office visits or consultations. Medicare specifies that they must be using a two-way telecommunications system that’s interactive and by a health care provider located elsewhere. Some areas have further requirements for coverage. If your service ticks all the boxes, Medicare will treat it like a corresponding in-person health care service. It’s also worth noting that some Medicare Advantage plans offer extra e-health coverage including things like 24-hour nurse lines.

Sometimes, you may notice the phrase telemedicine. Telehealth and telemedicine are not the same thing, though they’re very close. There’s an important distinction, though. Telehealth refers to a broad range of health care services that can span from clinical to educational services. Telemedicine only refers to remote clinical services, like virtual doctor’s appointments.

Pros of Telehealth

For seniors that find mobility or leaving home difficult, the benefits of telehealth are self-evident. They allow beneficiaries to meet with their doctor or specialist without making a strenuous or expensive trip. This service is invaluable to the homebound or seniors with mobility disabilities, which can make seeing the doctor a challenge. Furthermore, it brings access to health care to even the most rural or isolated communities that may otherwise have to travel a great distance to receive even the most basic health care services.

Telehealth is also useful for people with chronic conditions that have symptoms and health information that need monitoring. For example, a senior with diabetes may be able to use an application that allows them to note their blood sugar each day. At the same time, their doctor can monitor the app, allowing them to keep updated with their patient’s progress. These monitoring apps or patient portals gives beneficiaries access to their medical information around the clock!

Cons of Telehealth

The biggest con of telehealth is the lack of hands-on examination that the doctor can give you. Since the appointment is held via video chat or online, they’re largely making a diagnosis off what they can see and the symptoms you report. In some cases, like a cold or fairly straightforward illness, this isn’t a concern. But for a more complex diagnosis, being able to touch and test can be extremely helpful. It goes without being said that telehealth cannot replace emergency services.

With some of the coverage or reimbursement restrictions, it may also be more expensive to take part in e-health services. For this reason, it’s worth beneficiaries looking at their individual insurance plan, Medicare or otherwise, to make sure they know what’s covered beforehand. In some cases, even with added costs, it may save them money to use telehealth, especially if they require special transportation to visit their doctor.

Many health care providers have access to telehealth tools that allow patients to utilize these services. If telehealth is something beneficiaries may be interested in, they should talk to their primary care physician about what services they provide. It’s also worth looking at their Medicare plan to see what services are covered, whether that’s online appointments or chronic condition monitoring. With the help of their doctor and their Medicare plan, telehealth systems can become an invaluable tool in their overall health care package.

Further Reading — Telemedicine

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