Medicare and TelehealthMay 17, 2018
Do you have trouble getting to your doctor’s appointments? Do you have a disabling condition or a lack of adequate transportation? Medicare and Telehealth may be the solution for you.
What is Telehealth?
Telehealth is a way for you to access quality care without having to leave your home. It began as a way for patients in rural areas and those who are too sick to leave home to speak with their doctor, but now it’s becoming a way of the future.
“Telemedicine” refers to diagnosis and monitoring through technology, while “telehealth” refers to any and all digital health management or education. There are four main types of telehealth:
- Live Video – a real-time interaction between patient and provider.
- “Store-and-forward” – recorded photo and video (like x-rays) sent to a specialist
- RPM (Remote Patient Monitoring) – an electronic transfer of medical data
- mHealth (Mobile Health) – care and education (like alerts) via cell phone, tablet, or computer
Telehealth Growing in Popularity
AARP reported that in 2013, the Telehealth industry was earning only $14.3 billion. It is expected to reach $36.2 billion by next year! It has been said that the baby boomer population, who are all around the age of 65 in 2020, have greatly contributed to telehealth’s popularity. Seniors are excited about the idea of not having to leave home to speak with their doctors because leaving home has frankly gotten difficult.
It’s always best to see a doctor in person so that they can perform the best physical examination possible. However, if you find yourself in a situation where you can’t get to your doctor’s office, you can schedule an appointment or speak with a doctor at a digital clinic. HealthTap, Teladoc, and MDLive are just a few examples of virtual clinics. If you think you need a prescription or if you want to talk to a physician or counselor but can’t find a way to go do it, log into one of these websites instead!
Keep in mind that if you are hoping for a controlled medication prescription, such as for a steroid or antidepressant, you will most likely need to see a provider in person.
What Kind of Doctors use TeleHealth?
Telehealth isn’t just for primary physicians. You may be able to find a specialist doctor on a telehealth service as well!
Mental Health: Psychiatrists and therapists can talk to you via webcam or even phone call. A webcam is always ideal so that your therapist can read your body language and look you in the eyes while talking to you. Not only is this more convenient for everybody, but depressed patients may have an easier time picking up the phone than having to leave the house.
Teledermatology: Webcams may not be clear enough for a doctor to spot a skin issue, but telehealth also allows your doctors to coordinate care. If your primary physician spots a skin condition but wants you to see a dermatologist for a second opinion, your doctor may be able to use a telehealth system (the store-and-forward method) to send a high-quality picture of your skin condition to a dermatologist, saving everyone time and money.
Teleophthalmology: Similarly to dermatology, doctors can exchange high-quality photos of your eyes so that you can get the care you need even if there is not an ophthalmologist nearby. This is most useful for people living in rural settings where there is not an abundance of doctors and specialists.
Teleoncology: A cancer diagnosis may mean that frequent doctor trips are required, which can be tough for those living in more remote areas and for those who have a hard time leaving home. Teleoncology can allow doctors and patients to discuss care plans, monitor vital signs, and even exchange important images without ever having to meet in person. This can drastically cut down on costs and the toll that it can take on a person with a cancer diagnosis to have to frequently travel to a doctor’s office.
What Illnesses can be Treated by TeleMedicine?
Since doctors can prescribe treatments electronically, common illnesses like diabetes, allergies, arthritis, infections, and depression can be treated through telemedicine. As long as your doctor is able to connect with you and prescribe the appropriate treatment, telehealth works.
Telehealth Medicare Coverage
Medicare has strict guidelines as to what telehealth service can be covered.
The “store-and-forward” system is only covered by Medicare in Alaska and Hawaii. That means that if a patient who lives in Alaska or Hawaii has a medical concern but there is not a specialist available in those states, a doctor can use the store-and-forward system to submit medical records and imaging to a specialist in the continental United States.
To be eligible for coverage for telehealth medical appointments, you must live in an area that is outside of a metropolitan statistical area or is in a rural area with a primary or mental health care shortage. This tool can help you determine whether or not your address is eligible.
Additionally, the 2018 CHRONIC Care act allowed Medicare Advantage plans to provide more alternate coverage. This includes telehealth for anyone who lives in an HPSA, or Health Professional Shortage Area.
To find a Medicare Advantage plan with telehealth coverage, contact us! We can have an agent help you pick the best plan that is best for your needs. Just click here to request a call or call us now at 833-438-3676.
*This blog was originally published on May 17, 2018, and updated on September 13, 2019.