Because Medicare employs telemedicine, here’s what you need to know about costs and coverage:

This article has been reprinted with the permission of Nerd Wallet.

Proponents have long sought a wider adoption of virtual doctor consultations, but a coronavirus pandemic was needed to bring telemedicine to the mainstream. From mid-March to mid-August, more than 12.1 million Medicare recipients received some form of remote treatment this year to protect healthcare providers and patients from infection, according to federal data.

The boost was supported by the Medicare and Medicaid Service Centers. The Medicare and Medicaid Service Centers have taken dramatic steps to relax the rules and increase refunds for telemedicine visits.

Insurers and employers have been encouraging the use of telemedicine as a low-cost alternative to non-urgent care for years. However, because patients were cautious about enrollment and Medicare was slow to accept it, telemedicine was limited to certain types of visits to rural patients.

It changed with COVID-19. In response to the pandemic, CMS has removed barriers to telemedicine coverage, allowing patients across the country to access care from home.

New service added

This year, the agency is on the list of telemedicine to pay during this public health crisis, including seeing doctors other than COVID-19, seeing first inpatients by a new practitioner, discharge services, and heart and lung rehabilitation treatment. Service was added. The CMS has also increased the variety of healthcare providers available for telemedicine, exempted patients from paying their own expenses, and raised reimbursement rates to the same amount as for direct visits.

The rule changes have opened up more telemedicine options for both the original Medicare and Medicare Advantage, an all-in-one alternative offered by private insurance companies.

Dr. Saurabha Bhatnagar, Chief Medical Officer and Head of Technology and Performance at United Healthcare UNH, said:
Medicare and retirement. “I was surprised.”

It is not yet known if any of these changes will be permanent. The CMS pays attention to improper use and misconduct while assessing telemedicine usage during a pandemic. In August, the agency announced a proposal to permanently allow services such as home visit assessments and extend payments for some telemedicine services beyond the current coronavirus emergency.

“It’s hard to imagine just going back to what it was before,” CMS administrator Seema Verma wrote in an article in Health Affairs published in July.

Proponents are concerned that permanent changes may limit medical access for some patients. Elderly people who live in areas with limited broadband and low-income Medicare recipients and may not be able to afford the devices and phones needed to receive telemedicine services are particularly vulnerable. It may be.

reference: Those who pay more for the Medicare Advantage Plan will live longer

“Before making changes permanent, careful research is needed to determine if telemedicine in the current state is exacerbating inequality and how to remedy identified concerns,” said the Medicare Advocacy Center. Said in a press release.

Nevertheless, COVID-19 has somehow paved the way for telemedicine. Here’s what you can do to get the most out of this:

Understand when telemedicine makes sense

To avoid infection, Medicare beneficiaries use telemedicine as a safer alternative to all types of health care. However, it is important to remember that at more normal times, some cares are better suited for virtual visits than others. For example, a follow-up visit to an already diagnosed illness or condition may work, but it may be better to see a doctor directly for new health concerns.

Christopher Ciano, president of Aetna Medicare, says mental health services seem to be working particularly well in nature. Remote options may encourage people who would otherwise be unwilling to seek this help to take care of them, he says.

Use the technology you like best

Healthcare privacy laws and other government regulations limit the types of technology available to telemedicine providers to specific platforms. However, the pandemic has opened the door to all kinds of virtual communications, including everyday tools such as FaceTime and Skype.

“We want to make it as easy as calling a loved one at FaceTime to see a doctor,” says Bhatnagar.

to see: How to get the most out of your telemedicine appointments: 9 tips

In addition, the CMS refunds telephone services to healthcare providers at a rate similar to a direct visit. This is a big change. When making a telemedicine appointment, let your provider know which technology you are most familiar with.

Please check the out-of-pocket amount

Many Medicare providers and Medicare Advantage insurers are exempt from paying for telemedicine visits during a pandemic. In the future, Medicare patients may pay the same out-of-pocket costs as seeing a direct doctor. It’s a good idea to ask what your cost sharing is before your promise, as there are all the billing changes caused by the pandemic.

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Because Medicare employs telemedicine, here’s what you need to know about costs and coverage:

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