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What is telemedicine and how can I pay for it?

Written by: Elizabeth Walker
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Published on November 7, 2022.

If you’ve set up a video call with your doctor rather than going into their office in person, that’s considered a “telemedicine” appointment. While telemedicine isn't a new medical service, factors such as the COVID-19 pandemic have made it more popular than ever. In fact, nearly half1 of physicians in the U.S. now use telemedicine to treat their patients.

With telemedicine, people can more conveniently meet with their doctors to receive consultations, medical care, and prescriptions. That’s why 84% of employers2 believe it’s crucial to offer health coverage for both virtual and in-person services to keep employees happy. But many wonder if virtual appointments are paid for the same way as in-person doctor visits.

This article will cover everything you need to know about telemedicine, including its covered services, pros and cons, and how you can pay for your virtual appointment.

Check out our guide to see how you can use your health reimbursement arrangement (HRA) to pay for telemedicine appointments

What is telemedicine?

Telemedicine is a way of receiving medical care or counseling from a physician virtually through telecommunications instead of through an in-person office visit.

While telemedicine and telehealth are often used interchangeably, they are somewhat different. Telehealth goes beyond telemedicine because they cover non-clinical practices, like appointment scheduling, continuing medical education, and physician training.

Using telemedicine, you can discuss symptoms or health concerns with your physician or a nurse practitioner on your computer, tablet, or phone. You can often receive a diagnosis, review treatment options, and get any necessary prescriptions during your appointment.

The four common types of telemedicine are:

  • Synchronous: Also called “live telemedicine,” synchronous telemedicine is when a doctor and patient communicate in real-time through video visits or phone.
    • Another kind of live telemedicine visit is a facilitated virtual visit where the patient is at a specific site, like a health clinic, to access the diagnostic equipment needed, and the doctor is at a remote site.
  • Asynchronous: Often referred to as the “store-and-forward” method, this lets providers and patients share medical history and other information directly with each other before or after telehealth appointments via email, fax, or over the phone.
  • Remote monitoring: Remote patient monitoring allows for continuous observation of a patient’s medical condition, whether through direct video monitoring or through tests, images, or mobile medical equipment, which are then collected remotely.
  • Mobile health (mHealth): Mobile health is when healthcare and public health information is shared via mobile devices. Shared information may include general health educational information and disease outbreak alerts.

What types of services can I get using telemedicine?

Telemedicine isn’t practical for emergencies, like a health attack or stroke. However, telemedicine is very useful for simple concerns and consultations.

For example, if you’re on vacation and get sick with the flu, you can speak with your primary care provider through your computer. Or, if you need a regular prescription refilled, you can chat with your doctor and get a same-day prescription sent through to your pharmacy.

Your healthcare provider will decide whether a telemedicine or in-person visit is suitable for your specific health needs, but a wide range of virtual services can be available to you.

Services that you can generally receive through telemedicine include:

  • Lab or X-ray results
  • Mental health treatment, including online therapy and counseling
  • Recurring conditions, like migraines or urinary tract infections
  • Skin conditions
  • Prescription management
  • Urgent care issues like colds, coughs, and stomach aches
  • Post-surgical follow-up
  • Physical therapy and occupational therapy

Telemedicine isn’t just about receiving care. Your physician can also use telehealth solutions to send or request information about your health for their records.

Information your doctor may ask you to virtually send them can include:

  • Your vital information, such as weight, blood pressure, and blood sugar levels
  • Pictures of a wound or injury
  • A document detailing your symptoms
  • Medical records that may be on file with another healthcare provider, such as X-rays or lab tests

Your doctor may also send you certain medical information, such as:

  • Notifications or reminders to take or refill your medication.
  • Targeted methods of improving your diet, mobility, or stress management.
  • Detailed instructions on managing and treating your health condition at home and what critical symptoms you should watch out for.

What are the advantages of using telemedicine?

1. Convenience

There’s no doubt that one of the best benefits of telemedicine is its convenience. If you have access to the internet, you can attend virtual appointments from any location without needing to go into a physical office, making it especially beneficial for those in rural areas, elderly patients with limited mobility, and those without transportation.

With more businesses going remote, it’s convenient for employees too. Due to its popularity, one survey found that 32% of employers2 will be offering telehealth solutions in 2023, while 69% said they may offer these services in 2025.

2. Greater disease control

Using telemedicine in the event of a health crisis, like the COVID-19 pandemic, is particularly effective towards preventing the spread of disease in your community.

A physician survey3 found that 79% of doctors had fewer patient visits than before the pandemic. In an outbreak, telemedicine helps keep patients healthy and provides safe access to care, especially for those with immunodeficiencies, by limiting physical contact and implementing social distancing.

3. Easier chronic illness management

Telemedicine makes it significantly easier for at-risk patients, such as those with a chronic illness or chronic pain, to meet with their primary care physician or medical specialist regularly. If you have a family member who is elderly, telemedicine appointments also allow you to attend virtual visits and participate in the care of your family member from a distance.

Remote monitoring telemedicine services can be particularly important for those with chronic conditions, especially if they have limited movement. During check-ins, doctors can remotely see the patient’s location and look for potential health dangers that may worsen their condition.

What are the disadvantages of using telemedicine?

1. Reduced quality of care

Telehealth isn’t a perfect fit for every patient or medical condition as there’s a potential for gaps in healthcare, overuse of care, or unnecessary care.

For example, if you think you have a simple cold, but it turns out to be something more serious requiring urgent or emergency care, telemedicine may delay your treatment. Also, each time you access telemedicine, you may be assigned to a different physician, resulting in reduced care continuity with that doctor having access to your complete medical history.

Lastly, the physical separation that telemedicine inherently creates makes it hard to form a personal connection with your doctor. You may never get a chance to bond with or personally meet them, which can be isolating if you’re elderly, have a chronic illness, or you’re looking for a family doctor.

2. Diagnosis errors

When providers can't do a physical exam in-person, you risk getting the wrong diagnosis. Telemedicine can support many acute care illnesses, but certain ailments require a face-to-face assessment and, therefore, can’t be diagnosed properly in a remote setting.

Another potential pitfall is that telemedicine requires patients to describe their symptoms clearly to their doctor. If a patient forgets to mention a symptom or describes it inaccurately, their diagnosis may not be correct.

With all the benefits of telemedicine, it isn't possible to do every type of visit remotely. In some cases, you’ll still have to see your doctor for in-person care, like imaging tests, blood draws, and hands-on procedures to get the most accurate diagnosis possible.

3. Potentially limited access

While many individuals have access to the internet or a mobile device these days, not everyone does. People without access to this technology may not be able to use telemedicine services. Even if some public spaces, like libraries or community recreation centers, have free wireless internet, those without transportation may not be able to get there for their appointment.

There’s also the issue of technical or system problems. As with all technology, it’s possible for your internet to drop, wireless connections to malfunction, and videos to freeze. This can cause patients and providers to become frustrated with the remote setting and opt for the in-person visit instead.

How can I pay for telemedicine?

Due to the COVID-19 pandemic, most health insurance providers and programs expanded to cover some telehealth services, including federal Marketplace plans, Medicare, Medicaid, and private health insurance companies. Some states4 even have laws requiring health insurance plans to reimburse telemedicine visits at the same rate as in-person care.

However, not all employers offer a group health insurance plan. If you have a health reimbursement arrangement (HRA) or health stipend from your employer, don’t worry! Both benefits can be used to pay for telemedicine and other related out-of-pocket costs.

Let’s review both options below and how they work with telehealth services.

Health reimbursement arrangements (HRAs)

Any visits you have with a doctor—whether in-person, over the phone, or through video chat—are always reimbursable through an HRA. An HRA is an employer-sponsored health benefit designed to reimburse you, tax-free, for a wide range of medical services and qualified out-of-pocket expenses.

To get your appointment reimbursed through your HRA, whether in-person or telemedicine, you’ll need to submit documentation showing proof of purchase.

Your proof of purchase needs to include:

  • The specific service you received
  • The date you received the service
  • The cost of the service to you

Additionally, reimbursement health plans, like health savings accounts (HSAs), flexible spending accounts (FSAs), and HRAs, were expanded by the Coronavirus Aid, Relief, and Economic Security (CARES) Act to cover telemedicine and remote care services before a participant meets their deductible.

However, normal cost-sharing may still be required for telemedicine visits, like co-payments, after the deductible is met.

Health stipends

Another way to pay for telemedicine appointments is with a health stipend. Health stipends are a fixed amount of money provided by employers that employees can use to purchase individual health insurance plans and out-of-pocket medical expenses, including telemedicine services.

Because they’re essentially grossing up wages, stipends are taxable income for employees. However, they’re less regulated than group health insurance or HRAs, so stipends are a great option if you want more flexibility and choice regarding what you can use your stipend money to purchase.

If your employer is offering a stipend through PeopleKeep, your benefit will work similarly to an HRA. When you incur an eligible medical expense and submit proof of purchase, you’ll be reimbursed on your paycheck by your employer.

Conclusion

If you’re feeling sick or have a health concern, you can get medical care with a telemedicine appointment at the click of a button. Virtual appointments don’t remove the necessity of in-office doctor visits, but they certainly make receiving healthcare for certain situations more accessible and faster for millions of Americans.

If your employer is offering you an HRA or health stipend, you can get significant savings on a wide variety of healthcare expenses, including telemedicine appointments, all on a tax-free basis. With these two benefits, it’s easy to get reimbursed for expert medical counseling and care from the comfort of your home, giving you more flexibility and peace of mind.

This article was originally published on October 27, 2021. It was last updated on November 7, 2022.

1https://www.merritthawkins.com/uploadedFiles/Corona_Physician_Survey_Merritt_Hawkins_Report.pdf

2https://www.fiercehealthcare.com/payers/virtual-care-here-stay-employers-think-it-needs-evolve-reach-its-full-potential-survey-finds

3https://jamanetwork.com/journals/jama/fullarticle/2767633

4https://www.kff.org/womens-health-policy/issue-brief/opportunities-and-barriers-for-telemedicine-in-the-u-s-during-the-covid-19-emergency-and-beyond/#:~:text=PRIVATE%20INSURERS%20AND%20EMPLOYER%20PLANS

Originally published on November 7, 2022. Last updated November 7, 2022.
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