Telemedicine Insurance
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Telemedicine – Healthcare for Modern Patients
Find Health Insurance that Covers Telemedicine Services
Telemedicine has been making waves in the healthcare industry for a few years, and it’s becoming more prevalent. Global events have steadily brought telemedicine to the front of our awareness as a convenient and low-risk way for professionals to treat patients, without needing a visit to the office.
Telemedicine Defined
Traditionally, telemedicine described the delivery of healthcare services by a physician, physician’s assistant (PA), nurse, or another healthcare provider via telephone. Today, modern technology has given us access to video chat platforms like Skype, Zoom or Facetime. Video chats allow medical professionals the ability to assess a patient visually, with zero human contact.
After a discussion of the patient’s symptoms, the provider can diagnose and treat patients, offer them advice, and send a prescription to the patient’s preferred pharmacy.
Telemedicine is Ideal for a Host of Conditions
Any parent who has awakened in the middle of the night to a child screaming from a painful ear infection can likely identify and diagnose the issue. But they cannot acquire the needed prescription antibiotic without a visit to a physician’s office.
Some issues are a perfect match for telemedicine, like:
- Viral infections, like a common cold, influenza or Coronavirus
- Other communicable diseases like Norovirus or Rotavirus
- Staph infections
- Ear, nose and throat infections
- Conjunctivitis (aka Pink Eye)
- Mental and emotional health concerns
- Allergies
However, more severe conditions and acute injuries will likely still require a visit to a doctor’s office, urgent care or emergency room. Telemedicine is not appropriate for:
- Severe head and neck injuries
- Venomous snakebites
- Strains, sprains or suspected broken bones
- Chest pain
- Abdominal pain
- Hernia
- Puncture wounds that may require a Tetanus vaccine
Individuals interested in using telemedicine services should be aware of the differences between a potentially dangerous condition and a minor one. Therefore, telemedicine may not always be appropriate for folks who suffer from dementia or advanced Alzheimer’s disease. In situations like this, a thoughtful caregiver or family member should still be involved.
Telemedicine is Changing the Health Landscape
Telemedicine services are transforming the ways patients access healthcare. By receiving non-emergency medical care over the phone or via a video chat, individuals conserve the resources that would otherwise be spent setting up appointments, commuting, or spending time in the lobby with a physician.
- Patients can contact their telemedicine providers 24 hours a day, seven days a week, and get valuable advice and a prescription quickly.
- Medical professionals can address a patient’s concerns immediately, reducing stress and acting as the voice of reason, helping patients understand if they need to call an ambulance or head to an emergency room directly.
From a health insurance perspective, telemedicine lowers the risk of a communicable disease spreading within a community. It ultimately reduces medical claims paid.
Who Benefits Most from Telemedicine Services?
Historically, patients in rural, countryside settings were known to benefit most from telemedicine.
- The American Hospital Association (AHA) cited 2018 studies by Pew Research that proved most rural Americans had to travel twice as far to doctor appointments and hospitals, than those living in cities.
- The average city-dweller can get to a hospital in less than seven minutes, while rural residents travel at least ten to fifteen minutes.
- The longest hospital commutes were more than a half-hour.
During a medical crisis (real or perceived) every minute matters! So the ability to reach a physician or staff immediately with a question of severity was always most beneficial for those living remotely.
However, since the COVID-19 pandemic, the insurance industry, hospital boards, medical professionals and the patients they serve have all come to recognize the value of telemedicine as a way to provide non-emergency care.
Individuals living in urban settings are becoming more appreciative of the ability to seek medical assistance without having to battle commuter traffic, use public transportation and wait in a potentially infectious lobby.
Medicare Covers Telemedicine as of March 2020
For retirees, it’s essential to know that Medicare is now covering most telemedicine appointments.
The Costs of Telemedicine: Will Patients Save Money Using Telemedicine?
Telemedicine costs will vary by provider, by location, and possibly by network. According to Kaiser Health News, the average telemedicine appointment would cost about $79 out of pocket, compared to $146 for a regular doctor’s office visit.
For some patients, individual healthcare costs are sure to be mitigated by telemedicine; fuel expenses, public transportation costs, missed hours at work and for some families, paid child care. A physical appointment with a doctor can incur many circumstantial costs. In these situations, a “virtual” appointment with a telemedicine practitioner would present considerable savings.
Historically, telemedicine visits often led to a physical visit at a hospital or doctor’s office. About 12% of telemedicine visits were considered complete without a physical appointment. 88% of all telemedicine patients required a physical visit to a provider’s office or a follow-up appointment.
Still, that was before COVID-19. As of 2020, medical professionals and service providers across all fields of medicine have focused on providing remote services whenever possible. While it’s far too early in the game to speculate percentages, it wouldn’t be surprising if telemedicine completion statistics boast at least a 50% completion rate or better, from 2020 on.
Why Telemedicine is Gaining Popularity
About 80% of US residents own at least one “Smartphone” or another handheld device. Patients can reach medical professionals around the clock, from the privacy of their home, or even while taking a break at work.
Naturally, the COVID-19 pandemic brought telemedicine to the forefront of many patients’ minds, spurring its drastic growth in popularity.
Millennials, in particular, are fond of telemedicine. It makes sense because this generation is mainly comfortable with video-chatting services. While “Baby Boomers” are more likely to require an ongoing relationship and a certain “bedside manner” from practitioners, Millennials are more comfortable communicating via devices, even when it comes to sensitive, personal information.
Ultimately, the choice to involve oneself with telemedicine is a personal one. It’s not meant to replace traditional health insurance or traditional doctors’ offices entirely. Yet many patients find it to be a more affordable method to get non-emergency medical care.
Frequently Asked Questions (FAQs)
Get clear answers to common insurance questions and important details to guide your coverage decisions.
What does “telemedicine insurance” mean and how is it different from traditional health insurance?
Telemedicine insurance refers to virtual healthcare coverage for services like video or phone consultations. It allows patients to access care remotely instead of in-person.
How can I get a telemedicine insurance quote through EINSURANCE?
Use EINSURANCE’s quote tool by entering your ZIP code and desired health services. It will show you providers that include telemedicine in their health plans.
What key factors should I compare when evaluating telemedicine-insurance plans?
Check whether telemedicine is in-network, what virtual services are included, if there are separate copays, visit limits, and technology requirements (video/audio).
Are telemedicine visits covered by health insurance?
Many insurers now cover telehealth, especially post-COVID. Coverage depends on your plan and state. Medicare and Medicaid also support certain telehealth services.
Does my state’s law require coverage for telemedicine services?
Yes, several states require telehealth parity—meaning insurers must cover telemedicine similarly to in-person care. Check your state’s current laws for details.
What types of services are typically included via telemedicine?
Telemedicine may cover general primary care, mental health therapy, chronic condition management, follow-ups, and sometimes specialist consultations.
How do telemedicine benefits affect my cost (premium, copay, deductible)?
Some plans offer $0 virtual visits or reduced copays. However, full virtual-care coverage may increase your monthly premium depending on plan design.
What technology or user requirements must I meet for telemedicine coverage?
You’ll usually need a smartphone, tablet, or computer with internet and video capability. Some insurers may require apps or secure telemedicine platforms.
What happens if I live or travel out-of-state — will my telemedicine visits still be covered?
Coverage varies based on provider licensing and plan rules. Some plans support nationwide or cross-state virtual care, while others are state-restricted.
How do I use the telemedicine benefit with my insurance?
Log into your insurer’s portal or app, find a virtual care provider, schedule a visit, and pay any copay. Always check your plan benefits beforehand.
