As we are coping and coming to terms with the current COVID-19 pandemic, we’re still staying home as much as possible. Meanwhile, the healthcare system is scrambling to provide pandemic-related health services in addition to other essential services.
In this “new normal,” the adoption of telemedicine and telehealth has skyrocketed! While regulations put in place for COVID-19 continue to change, many of them are being waived or relaxed for tele-services. In a matter of weeks, some of the biggest barriers to tele-services have been lifted. For example: Federal insurances, like Medicare, have started paying for virtual visits as they do for normal office visits.
This means that telemedicine and telehealth are becoming more available, which has created a lot of chaos for both healthcare providers and patients.
- How do we make sense of the current healthcare landscape?
- How do we access services that are necessary for our health and wellbeing?
Telemedicine Vs. Telehealth
First, let’s distinguish these two terms. Telemedicine is the use of electronic information and telecommunication technology to support long distance clinical healthcare, health-related education, etc. Technologies include video conferencing, the internet, cellphones, etc.
Telehealth is different from telemedicine in that it refers to a broader range of healthcare services. Here’s a good breakdown:
- Telemedicine refers to remote clinical services provided by a licensed healthcare professional
- Telehealth can refer to non-clinical services such as trainings, support and meetings in addition to clinical services
Pros and Cons of Telemedicine/Telehealth
Pros of telemedicine and telehealth:
- Less exposure to illness
- No need to take time off work
- Minimizes the need for child or elder care
- No transportation time or costs
Cons of telemedicine and telehealth:
- Dealing with different technologies
- Privacy and security
- Variation in insurance coverage
- Potentially spotty access to internet or data
Common Q & A’s
Q: Is a telemedicine or telehealth visit as effective as in-person?
A: Studies show that remote visits are equally as effective as in-person. However, there are situations when in-person care is necessary. You need to discuss your situation with your healthcare provider.
Q: Is my privacy protected?
A: A telemedicine or telehealth system should be HIPAA compliant at the very minimum.
Q: Can medications be prescribed?
A: Rules vary by state. In most cases, medications can be prescribed with the exception of controlled substances.
Q: Where do I go for my visit?
A: Most people prefer their home or private office, but you can use any location as long as it isn’t noisy and gives you enough privacy.
Q: What equipment do I need?
A: All you need is an Android or iPhone mobile device (any smartphone really), a home computer or a laptop.
Q: How much does it cost?
A: Telemedicine and telehealth are typically covered by health insurance. However, it is best to call your insurance provider before a visit. Also, beware of out-of-pocket costs such as a convenience fee.
Q: How do I schedule a visit?
Contact your provider’s office as you would for an in-person visit and ask for a telemedicine/telehealth visit option.
Medicare Coverage Example:
Since early 2020, Medicare Advantage Plans may offer more telehealth benefits than in the past. These benefits can be available in a variety of places, and you can use them at home instead of going to a healthcare facility. Check with your plan to see what additional telehealth services are offered. For example, telehealth visits can be used in places including home, nursing homes or assisted living facilities.
Costs: In original Medicare, you paid 20% of a Medicare-approved amount for your doctor, and part B deductible applied. Call Medicare for up-to-date information about your out-of-pocket costs.
Who can provide services:
- Physicians, nurse practitioners, physician assistants
- Licensed social workers
- Clinical psychologists
- Physical, occupational and speech therapists
Note: The Centers for Medicare and Medicaid Services (CMS) issued guidance on new and expanded flexibilities given to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) during the COVID-19 Public Health Emergency (PHE) crisis. The CARES Act (HR 748) allowed FQHCs and RHCs to utilize telehealth and act as distant site providers during a PHE.
Private Insurance Coverage Example:
Horizon Blue Cross Blue Shield of New Jersey
During the current COVID-19 public health emergency, the following changes have been announced:
- Phone calls, video calls and online/health portal communications are all covered services (for established patients only)
- The following services have been temporarily added: Audiology/tinnitus assessments; behavioral health assessments; behavioral health counseling; behavioral health OBAT/MAT services; hearing aid checks; occupational therapy evaluations; physical therapy evaluations; self-management education services and speech therapy services.
Regular Medical Care
Despite the current pandemic, there is still a need for healthcare in the case of urgent events like stroke, heart attack, dental emergencies, cancer treatment, etc. It is crucial that we seek care in these scenarios without delay. Healthcare systems continue to streamline efforts to care for such events in facilities that are less affected by COVID-19.
However, routine care is equally important for chronic conditions such as diabetes, heart disease, high blood pressure, weight management and arthritis. If care is delayed, it can lead to harmful outcomes. We should try to receive this care remotely (telemedicine/telehealth) as much as possible. If remote access is not available for routine screenings and elective procedures, they may be deferred for a later date. It’s always a good idea to check with and follow recommendations from local and state health departments.
Other telehealth services that may be covered:
- Nutrition counseling
- Behavioral counseling for obesity
- Diabetes management
- Health coaching
*Note: Coverage may vary from state to state and across insurance providers.
Coronavirus (COVID-19) has affected both the economy and the healthcare system. Healthcare’s utmost priority is to provide care in the safest way possible and to prioritize it for those who have serious health conditions and are at risk for complications from delayed care. For the general population, especially those with chronic conditions, care should not be delayed if those conditions are worsening.
Important things to remember:
- Know your insurance provider’s telehealth policy and fees
- Contact your provider to see if they can see you via telehealth
- Make sure you have enough of your prescription medications
- Don’t forget about your general health and wellness
- Don’t delay any urgent medical problem
Example of Online Telehealth:
(Please note that Your Weight Matters does not endorse any specific virtual health platform or service. The following are examples of different kinds of online telehealth services)
- Weight Watchers virtual coaching
- Fitbit Care Wellness Program
About the Author:
Sunil Daniel, MD, FTOS, is a board certified obesity medicine physician with fellowship training in clinical nutrition and obesity management. He is a fellow of The Obesity Society and has authored several scientific papers on obesity and its medical management. He is also an OAC National Board Member and serves on the Education Committee.