How It Works And How To Get The Best Rates
You have an ache, pain, or other health problem interfering with your life, and it’s finally time to see a doctor. That is, if you can find an appointment slot that works for both you and the provider, wait for the appointment, get yourself there, and pay the bill when it arrives (whatever that costs).
Or, your pain is getting so acute you’re thinking about an urgent care clinic, but you know their bill will be enormous. With all the hassle, it’s no wonder busy young people put off routine health care.
Then the COVID-19 pandemic hit, making a doctor visit not just an inconvenience but a health risk of its own. Providers in most health care fields had to change up their strategy by adding options for remote visits, where patients met with doctors via phone or video. Any care that could be delivered remotely, like therapy, prescription refills, or general health advice, pivoted to a virtual “telehealth” model.
And telehealth isn’t going anywhere — in fact, it’s becoming the new normal. Not only does telehealth save time, but it also saves patients a ton of money.
What is telehealth?
“Telehealth” includes any remotely provided medical care, from doctors’ appointments to pharmacies, nursing, and social services. You might be using some form of telehealth already — the digital healthcare trend extends to fitness apps, exercise trackers, and health monitoring devices.
The similar term “telemedicine” refers specifically to diagnoses and treatment provided by medical doctors or specialists, while telehealth encompasses all kinds of healthcare.
Is telehealth here to stay?
Even before the COVID-19 pandemic kept us all stuck at home, many doctors provided telephone consultations (hence the name “telehealth”) for patients who couldn’t make in-person appointments.
These days, healthcare professionals are seeing a staggering increase in requests for remote services, and a McKinsey & Company survey reports 64% of care providers are more comfortable using telehealth than they were in the past. In March 2020 the Centers for Medicare & Medicaid Services (CMS) started reimbursing providers for telemedicine visits at the same rate as in-person visits, a shift the center plans to make permanent.
The healthcare industry is realizing consumers want virtual options; as a result, many providers are expanding remote offerings and looking into long-term telehealth models. Hospitals, ICUs, and emergency rooms will keep providing hands-on treatment, but for other kinds of care, almost all physical services will have a digital equivalent.
Some experts predict a rise in “virtualist” primary care doctors who use telemedicine to screen patients for conditions that can be diagnosed and treated remotely, referring them to in-person care only as needed.
Technology, of course, is getting better and better, and remote devices help doctors listen to your heart and look into your ears through a screen. Simpler devices patients can use themselves, like blood pressure cuffs, might become common in homes.
Remote providers will also continue to prioritize protecting your personal health info—telehealth providers are held to the same HIPAA privacy and accountability standards as in-person providers, and healthcare sites and apps should explain their security measures.
What services can telehealth provide?
Telemedicine adapts to all kinds of health care services, like:
- Routine primary care checkups.
- Follow-up visits.
- Prescription medication.
- Cancer screenings (in some cases).
- Urgent care services (rashes, respiratory conditions, etc.).
- Vision care.
- Nutritional counseling.
- STI/STD testing.
- Behavioral health—therapy and psychiatry.
- Prenatal care.
- Obstetrics and gynecology.
- Reviewing medical test results.
- Management of chronic conditions (diabetes, asthma, cardiac conditions, etc.).
- Several types of specialty care, like oncology, neurology, and even physical rehabilitation.
What services require in-person treatment?
For now, at least, medical procedures and imaging tests — including preventative screenings like mammograms — require patients to go to a medical facility. And for acute, severe conditions, like heavy bleeding, the in-person ER or urgent care clinic is still your first stop.
Dental care is also likely to remain hands-on for the moment. While some dentists provide observation and diagnoses via video, cleanings and fillings obviously can’t be done virtually.
How does telehealth work?
For everyday healthcare, larger primary care providers often set up online portals where you can easily schedule appointments or refill prescriptions.
Virtual visits work pretty simply—you’ll consult with a doctor via phone or video chat, going through a Q&A process about symptoms and medical history just like an in-person appointment. Working Internet or Wi-Fi is a must, and a phone, tablet, or computer should work fine as long as it’s compatible with the platform your care provider uses.
You may be asked to provide some data, like height, weight, and temperature, that nurses would ordinarily collect. And doctors can analyze some physical symptoms, such as rashes, by looking at a photo.
Minor health issues may not require an appointment—some facilities have virtual nursing “call centers” where nurses provide basic health care advice (but don’t diagnose or prescribe).
Can doctors prescribe medication via telehealth?
In most cases, yes. Doctors and nurse practitioners can send electronic prescriptions directly to the pharmacy so you’ll get them quickly. But some medications, including any controlled substances, are illegal to “e-prescribe” (the specific medication laws depend on your state). And some healthcare providers may be uncomfortable prescribing medication via phone or video.
How can telehealth save you money?
Remote appointments almost always come with a lower copay than their in-person counterparts, thanks in part to insurance companies charging lower rates. Aetna, for instance, offers free copays for telemedicine consults with in-network doctors.
United Healthcare estimates a typical virtual visit to a doctor for a minor health issue or an urgent care consult costs $50 in copays. By contrast, a physical consultation for a minor issue costs around $85, an urgent care visit is closer to $130, and a trip to the emergency room can stretch into four figures.
If you need follow-up consultations (for instance, if your doctor wants to check in about your response to a new medication, or you have unexpected side effects), you can save even more on lower copays for repeat visits.
Time is money, whether you’re taking two hours off work for an appointment or putting gas in the car for a 40-minute drive.
Since telehealth appointments are usually shorter and easier to book than in-person ones, the actual process goes much more quickly. An average telehealth visit takes less than half an hour, and you may be able to book a same-day appointment. Physical visits, by contrast, last around two hours—and you usually have to schedule at least two weeks in advance. A rapid telehealth diagnosis for a non-emergency condition can get you treated right away, with no sitting around in the waiting room.
Fewer emergency room visits
This is where patients and providers net the biggest savings. If you’ve gotten an emergency room bill, you know they’re not cheap, even after insurance. The cost of an ER visit can run into the thousands once you add up the price of any tests, scans, or specialists. And because the ER is always open, it’s often the first port of call for a health issue that might need urgent care but might also be treatable at home. Either way, the ER is going to bill you.
With telehealth, you can check in remotely with a medical professional — your busy primary care doctor is more likely to have time for a virtual consult than to see you in the office — and get more information about the next steps.
Not only will you save hundreds of dollars with each averted visit, but telehealth can also help you catch and treat health problems before they turn into genuine emergencies. If cost and time concerns are keeping you from getting that weird symptom checked out, even if you know it might get worse and more expensive down the road, virtual consultations leave you no excuse not to be proactive.
Several major telehealth providers charge a fixed, upfront flat fee for a doctor’s consultation. That way you can budget for the visit beforehand, rather than getting a surprise bill afterward. Teladoc, one of the biggest telehealth platforms, starts at $75 for a “general medical” visit. Amwell, another popular platform, charges $79. Keep in mind this doesn’t include the cost of any medications or follow-up visits.
Jefferson Health, based in Philadelphia, experimented with this pricing model by charging patients a $49 flat fee to use its online platform. After studying 650 patients, the staff found most of the patients’ health concerns could be addressed through virtual visits, heading off the large bills they would otherwise get at an urgent care clinic or ER.
Does health insurance cover telemedicine?
More insurance companies, even those that may have been reluctant to cover telehealth before, are joining providers on the telehealth train.
Twenty-six states have “parity laws” requiring insurance companies to reimburse providers for telemedicine video visits (and, naturally, passing the cost savings on to consumers). This chart by eVisit can tell you more about the legislation in your state. Many insurance plans cover telemedicine even if they’re not legally mandated to do so.
Some states or insurance companies may have additional requirements for telemedicine coverage, like a previous in-person visit or an established provider/patient relationship.
If you’re looking for a new insurance plan that does cover telehealth, eHealth marketplace partners with some of the best-known insurance carriers in the business, like United and Aetna, along with private local providers in almost every state. You can compare quotes from up to four providers at once and choose a policy that best fits your needs.
Where to find a telemedicine provider
If you already have a doctor, medical practice, and/or health insurance you’re happy with, that makes the job easier — just see what telehealth options they offer. Your insurance coverage comes with a list of in-network providers for different specialties, and the list may indicate which providers use telemedicine.
The federal government operates its own telehealth site with resources, including a list of low-cost and sliding scale health centers across the country that provide telemedicine.
Some platforms specialize in matching patients with telehealth providers. The big ones are Teladoc, Amwell, Doctor on Demand, and MDLive. Their pricing models vary, and so does the insurance they accept, so it’s worth shopping around. Smaller services like K Health can connect you to primary care doctors and mental health providers for a reasonable upfront fee (K Health charges $9 a month for unlimited doctor consultations).
Chances are you’ll use some kind of telehealth service in the near or distant future, as the field expands and offers more affordable options. Telemedicine’s convenience and cost savings make it even easier to keep on top of your appointments — and possibly stop major health problems before they get started.