Apr 26, 2020
Q: I have seen the term telehealth in the news
recently. Can you explain what it is and how to use it?
NT
Answer: Telehealth, also known as telemedicine
or virtual care, is health care provided via the internet usually through
online video, similar to Skype or Facetime. Only a few basic things are needed
to have a telehealth visit. You will need an internet connection, and a
computer, smart phone or tablet. One of these devices should have a microphone,
camera and headphones, if you would like privacy. Using telehealth is a
personal, easy, safe and efficient way to ask your doctor questions about
symptoms, refill a prescription or talk to a mental health professional.
So, how do you access telehealth? Just call
your doctor’s office and the staff can provide you with instructions over the
phone or through email on how to get started. Usually, the doctor’s office will
set up an appointment with you during the initial call. Once your appointment
is set, an email will be sent to you with a link. At the time of your
appointment you simply click on the link to talk to your doctor face-to-face
through video chat on your computer, tablet or smartphone. More steps may be
involved depending on the doctor’s office, but the staff should be able to walk
you through any questions and help you to connect.
Telehealth can make going to the doctor feel
as easy as calling your family and friends. It is generally a great option if
you cannot drive or otherwise transport yourself to your physician’s office and
can provide a sense of independence in managing your health.
Of course, not all doctor visits can be done
over video chat. When you call your doctor’s office they will let you know if
your visit can be done remotely. For instance, if you need a physical
examination or diagnostic test, an in-person doctor’s visit will likely be
required. In the current health emergency, if you develop symptoms of COVID-19,
such as a fever, dry cough or shortness of breath, call your doctor’s office to
ask what you should do. Do not visit the office unless otherwise instructed.
Q: Are there any changes to Medicare regarding
testing and treatment for the coronavirus?
Answer: There is a great deal of uncertainty
around the coronavirus with information changing day-to-day regarding safety
and other guidelines. You are not alone in wondering how Medicare is adjusting
medical costs related to COVID-19. The Centers for Medicare Services has
responded to the pandemic with recent updates.
One change recently announced includes
coverage for any testing necessary for the coronavirus (after Feb 4) under
Medicare Part B. Those with Medicare Advantage plans will have all testing
costs covered as well. All cost-sharing/co-pay provisions have been eliminated.
To date, testing has been mostly confined to those individuals who are showing
symptoms related to the virus. For any changes to current testing procedures
and who can get tested check the North Carolina Department of Health and Human
Services website, ncdhhs.gov for
updates.
In addition, any in-patient treatment
associated with the coronavirus at a hospital will be covered under Medicare
Part A. Patients admitted to a hospital will be responsible for any related
Part A deductibles and co-insurance. Those with Medicare supplement plans will
have coverage for the Part A deductible as well as the co-pays for extended
hospital stays up to an additional 365 days. Part A Medicare deductible in 2020
is $1,408 per each benefit period and co-insurance for each benefit period is
$0 per day for days 1-60, $352 per day for days 61-90 and $704 per day for days
91 and beyond.
Treatment for the coronavirus on an
out-patient basis will fall under Medicare Part B. Individuals are responsible
for any applicable deductibles and co-insurance. Again, those with Medicare
supplement plans will have coverage for the 20% co-insurance under Part B and
may have coverage for the deductible depending on their specific plan. Part B
Medicare deductible in 2020 is $198 and co-insurance is 20% of the Medicare approved
amount for the service. Out-patient coverage for those with Medicare Advantage
plans will depend on the specifics in each plan depending on their insurance
carrier. Visit medicare.gov/your-medicare for more
details or call 1-800-MEDICARE(1-800-633-4227).
Medicare Advantage plans and some prescription
drug plans normally limit coverage for service from out of network providers.
Importantly, all restrictions regarding using out of network providers have
been waived during the coronavirus outbreak. The Medicare Advantage and
prescription drug plans must offer coverage for out of network providers at the
same costs as in network providers.
With the COVID-19 pandemic, we are all trying
our best to stay home as much as possible. To aid in that, for the duration of
the COVID-19 outbreak, Medicare has expanded coverage for telehealth visits.
Restrictions on telehealth services for Medicare Advantage plans have been
eliminated also. Now, under the new Medicare expansion of benefits older adults
may have telehealth care covered in the same way as if going to a doctor in
person. This allows those with Medicare coverage an option to speak to a doctor
without ever leaving their home. A list of telehealth services can be found at
the Centers for Medicare & Medicaid Services website, cms.gov or
your doctor’s office should be able to let you know which services are covered.
Keep in mind, there is currently no vaccine
available for the coronavirus. The Centers for Medicare Services will provide
more definitive guidance on vaccine coverage as vaccines are developed for the
virus.
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