Use of telehealth in the United States was relatively nominal prior to COVID-19. In the wake of the pandemic, however, with many hospitals at capacity to treat patients, doctors, clinics, hospitals, insurers, and government have looked to telehealth as a viable way to deliver care to patients in their homes and thereby reduce the risk of spreading the virus.

What is telehealth and how can it help during the COVID-19 outbreaks?

Telehealth refers to the use of technology – everything from telephones to video calls on smart phones, tablets, or computers – to provide health care and related services, such as clinical education, remotely. Telehealth covers a broad range of applications. Applications that are patient-focused are commonly known as:

• Virtual appointments: live, two-way interaction between a person and his or her doctor or other health professional using audiovisual telecommunications technology.
• Patient portals: secure, web-based platforms that allow a person to communicate with his or her doctor or a nurse, schedule appointments, request prescription refills, and discuss test results.
• Doctor to specialist consultations: transmission of recorded health history (usually by a primary care physician) through an electronic communications system to a practitioner, usually a specialist, who uses the information to evaluate the case or provide a health service outside of a real-time interaction; may include transmission of electronic radiological records, lab results, and other diagnostic tests.
• Remote Patient Monitoring (RPM): personal health and medical data collection from an individual in one location via electronic communication technologies, which is transmitted to a doctor in a different location for use in care, treatment planning, and related support.
• Mobile Health (mHealth): Health care and public health practice and education supported by mobile communication devices such as cell phones, tablet computers, and PDAs. Applications can range from targeted text messages that promote healthy behavior to wide-scale alerts about disease outbreaks; other mobile health devices include personal health apps that allow people to organize their health information, track calories and activity daily, schedule medication reminders, etc.

In February 2020, the Center for Disease Control & Prevention (CDC) published guidance advising the public and health care providers in areas affected by the COVID-19 pandemic to adopt social distancing practices.  Specifically, the CDC recommended that health care facilities and providers offer clinical services through virtual means such as telehealth.

The CDC stated telehealth could have multiple benefits during the pandemic by expanding access to care, reducing disease exposure for staff and patients, preserving scarce supplies of personal protective equipment, and reducing patient demand on facilities. From its study, the CDC reported telehealth visits the last week of March 2020 increased 154% from the same period in 2019.  Changes in provider and consumer behavior as well as health policy changes in response to the pandemic contributed to the surge in telehealth.  

For many consumers, telehealth provides a convenient means of getting care and medical advice while continuing to practice social distancing. Telehealth may sound complicated, but for many it’s as easy as connecting with friends via video chat. If you’d like to look for individual or family health insurance plans with telehealth coverage, eHealth’s plan comparison tool and team of experienced agents can help you find the plan for you.

How does telehealth work?

Starting a virtual telehealth visit with your doctor may be as simple as placing a call with your telephone.  But to set up a video visit, you will need a computer, tablet, or smartphone with a camera and microphone. Usually the practice staff will ask you if you want to schedule an in-person or virtual visit. If you choose the latter, the staff will instruct you on how to access the practice web site or download the practice’s app. At the time of your scheduled appointment, you and your doctor sign into the app or website portal to begin your visit.

Virtual visits aren’t limited to video-conferences with your primary care physician. In many cases, you may set up a visit with a nurse practitioner, physician assistant, psychologist, or a specialist, such as a dermatologist.

When should you consider telehealth?

Telehealth is a great option for treating common health issues. But it should not be used in the event of an emergency or severe illness when immediate, personal care is needed or when tests are necessary to diagnose and treat your condition. Telehealth has some practical limitations, also.  To use it effectively, you and your healthcare provider must have the technology to support telehealth visits.  This means broadband internet as well as audio and video capabilities.

If you have the technology, you may want to consider using a virtual appointment to treat conditions such as:

• Allergies
• Colds and flu
• Diarrhea or constipation
• Infections
• Conjunctivitis (or pink eye)
• Skin rashes, infections, or inflammation
• Sore throats
• Joint aches and pain
• Headaches
• Small wounds and cuts

You can also use virtual telehealth visits for routine follow-up appointments and prescription refill requests. Depending upon your health condition, your doctor may suggest remote patient monitoring to check your blood pressure and heart function if you have experienced a change in your heart condition or medications to treat it.

Does my insurance cover telehealth?

Telehealth coverage depends on your insurer.

• If you have Medicare Part B (medical coverage), then the answer is yes. Medicare expanded coverage for telehealth services on March 6th 2020, via Waver 1135, to help reduce the strain on healthcare professionals during the coronavirus outbreak and promote safe access to care for beneficiaries. Similarly, Medicare Advantage plans offer telehealth benefits.
• Tricare provides expanded coverage for telehealth services.
• Most state Medicaid programs provide expanded coverage for telehealth services

According to the American Telemedicine Association (ATA) most private insurers provide some level of coverage for telehealth services. Since the onset of COVID-19, approximately 32 states and the District of Columbia have passed laws that require insurance carriers to provide coverage for telehealth services. A number of large employer sponsored health plans have extended telehealth coverage as well, at least for the duration of the public health emergency.

Some important information about private insurance and telehealth coverage:

• Coverage varies among plans.  Some may cover telehealth visits at the same level as in-person visits. You pay your office visit copayment. Others may have different cost-sharing arrangements for telehealth coverage.
• Insurers may have temporary and permanent telehealth benefits. For example, some private insurers have followed Medicare in waiving member cost-sharing for COVID-19 related care during the declared emergency. Cost-sharing resumes when the public health emergency is over.
• Insurers may have rules or restrictions on certain telehealth services. For example, you may have to use telehealth services of providers in the plan’s network for the insurer to pay covered benefits.
• Before scheduling a telehealth visit, it’s a good idea to contact your health insurer to check your coverage.

You can learn which health insurance companies offer telehealth coverage by visiting eHealth’s health insurance by state page. Then select the insurance company’s plan and click on coverage details. Usually “telemedicine” or “telehealth” appears in the additional coverage information section.  If you prefer, eHealth licensed agents can always help you understand an insurance company’s telehealth coverage, limitations, or exclusions.

If you are considering your health insurance options for your 2021 individual or family coverage, eHealth is here to help you. Our licensed insurance agents and brokers are available to answer your questions and make recommendations about plans that best meet your needs. To explore health insurance options, simply click here: Individual & Family Health Insurance.

For information and guidelines specific to the coronavirus outbreak, visit cdc.gov

This article is for general information and should not be relied on as medical advice. Check with a medical professional for medical advice.  Check with your particular insurance company to see what is covered by your particular insurance plan.