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Telehealth Coverage During the Coronavirus Pandemic


Traditionally, if you needed medical care you’d head to your doctor’s office, urgent care clinic or even the emergency room. With the COVID-19 pandemic keeping many Americans home, telehealth services have emerged as an alternative to in-person care. Being able to consult a doctor remotely can be convenient, but what exactly does it involve and who does it benefit? If you’ve never used telehealth services before, you may be wondering what it covers and how much it costs. This guide covers the most important things to know about telehealth coronavirus services.

Telehealth Services, Definition

Telehealth and telehealth services offer a way to access healthcare digitally, via computers or mobile devices, without having to go to a doctor’s office. It’s an updated version of the house call where, instead of coming to your home physically, your doctor or healthcare provider can meet with you virtually.

Telehealth services can work in different ways, depending on where you live and what your healthcare provider offers. For example, you may be able to take advantage of telehealth services using any of the following:

  • Virtual appointments. Virtual appointments allow you to schedule a video conference with a nurse practitioner, doctor or another healthcare provider at a time that’s convenient for you.
  • Online information portals. If your healthcare provider has an online patient portal, you can log in to view your medical history, check test results, manage in-person appointments or send secure messages to your doctor.
  • Remote monitoring. Telehealth also includes remote monitoring services. For example, if your doctor has you wearing a device to monitor your heart rhythm, the data from the device could be transmitted digitally without requiring an office visit.
  • Prescription refills. If you regularly take medication, telehealth services could make it easier to get prescription refills or consult with a doctor to determine if your prescription needs to be changed, without an in-person visit.

Using telehealth services can offer numerous benefits, especially during a global health crisis when you may be unable or unwilling to venture far from home. You can schedule virtual appointments, get recommendations for treatments or guidance on potential COVID-19 symptoms from a nurse or physician and manage your healthcare records online. Telehealth services may also be particularly helpful if you live in a smaller community with limited access to traditional healthcare.

How Much Does Telehealth Cost?

If you’re concerned about keeping your healthcare costs to a minimum, you’re likely interested in how a telehealth visit compares to going into the doctor’s office. According to one study conducted by RAND, the average telehealth visit costs $79, compared to $146 for an office visit.

That’s a decent amount of money saved but the study also pointed out that telehealth visits may entail additional costs if you need follow-up care in a doctor’s office. That being said, using telehealth services for basic healthcare services, such as having symptoms diagnosed or getting a prescription updated, could be more affordable for your budget compared to going to the doctor in-person.

Telehealth visits can also be most cost-friendly than going to urgent care facilities or to the emergency room. The average urgent care clinic visit runs $168, while it may cost you just over $2,200 on average to visit the emergency room. Going to the emergency room or an urgent care facility may seem like the only option if your regular doctor doesn’t have any open appointments but it can be costly. If you’re not experiencing an emergency situation, telehealth services may be the better option.

Telehealth Coronavirus Coverage and Costs

Physician on a PC screen

The COVID-19 outbreak is reshaping the way people pay for telehealth services, including those who are covered by Medicare and Medicaid.

If you have Medicare, you should know that the program has temporarily expanded its telehealth services coverage to offer more accessibility and more ways to connect with healthcare providers through the pandemic crisis. Specific services are available for Medicare beneficiaries who use telehealth, including:

  • Medical evaluations
  • Mental health counseling
  • Preventive health screenings

Preventive health screenings don’t have a co-pay if you have Original Medicare coverage. Medicare also pays for virtual check-ins with your doctor or healthcare provider when you don’t have a medical appointment scheduled in the next seven days or the virtual visit doesn’t require you to see a doctor in person within the following 24 hours. Medicare will also cover communications between yourself and your doctor using online patient portals.

Medicaid programs are state-specific so whether your coverage extends to telehealth will depend on where you live. You can reach out to your state’s social services department to find out what, if any, telehealth services may be covered by Medicaid either temporarily or permanently as a result of the COVID-19 outbreak.

Telehealth Services and Insurance

States are also taking action differently with regard to insurance companies, with some states requiring insurers to waive copayments and other costs for telehealth. And in some instances, insurers are taking action themselves to make telehealth coronavirus services more affordable and available. For example, all independent and locally operated Blue Cross Blue Shield companies are waiving cost-sharing temporarily associated with telehealth services for fully insured members.

If you have health insurance, your carrier should be able to tell you whether you’re covered for telehealth services and how much you may have to pay, if anything. If you don’t have insurance, you can still access telehealth through private pay services. For example, companies like Teladoc and Amwell allow you to connect with a doctor or healthcare provider from home in exchange for a flat fee.

When looking into telehealth services that are private pay, consider the costs, how you’re able to communicate with a health care provider and what services are covered. If your finances are tight due to coronavirus, your best bet is to look for the private pay telehealth company that offers the broadest range of services for the least amount of money.

The Bottom Line

Physicians discuss a patient's diagnosisTelehealth services could spare you the time and money of going to a doctor’s office physically, not to mention potentially limiting your exposure to people who may have coronavirus symptoms. If you have Medicare or Medicaid, your out of pocket costs may be covered but it’s helpful to check your state’s Medicaid guidelines to be sure. Taking time to compare private telehealth services for cost and coverage can help you find the right option if you don’t have health insurance.

Tips for Covering Medical Expenses

  • A financial advisor can help you build a financial plan that takes medical expenses into account. If you don’t have a financial advisor, finding one doesn’t have to be complicated. SmartAsset’s financial advisor matching tool can help. This tool helps you connect with professional advisors in your local area just by answering a few brief questions. If you’re ready to be matched with local advisors who will help you achieve your financial goals, get started now.
  • The Family and Medical Leave Act protects the jobs of workers who need to take an unpaid leave of absence, for specified reasons, of up to 12 weeks. In March 2020, Congress extended those benefits for workers, provided the reason for taking a leave stems from the coronavirus pandemic. Also, check out this guide to the Families First Coronavirus Response Act and the CARES Act, both of which offer support for those who contract COVID-19.

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