The cost of a virtual health visit has changed for some people with insurance, even as the coronavirus pandemic rages.
That means you may have to pay more to Zoom with your doctor.
At the beginning of October, many major insurance companies, including Anthem and UnitedHealth, shifted their policies for telehealth, meaning that cost-sharing for some visits is no longer waived. The changes mostly apply to non-coronavirus related visits, and to people not receiving Medicare.
Telehealth has been around for 30 years and the Covid-19 crisis spurred exponential growth, said Kathy Wibberly, director of the Mid-Atlantic Telehealth Resource Center.
The pandemic led to policy changes that eliminated many former barriers to the adoption of telehealth, such as reimbursement and HIPAA privacy rules, Wibberly said.
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"We just made it easy," she said. Covid-19 also changed the status quo — patients and doctors needed to do visits differently to avoid spreading the virus.
Before the crisis, the virtual urgent care at NYU Langone in New York would see maybe 25 patients on a busy day, said Paul Testa, an emergency medicine doctor and the hospital's chief medical information officer.
In March, those volumes took a huge turn. "In a matter of two weeks, we were seeing nearly 1,000 patients a day," said Testa. Now, months after the pandemic first hit New York, the virtual urgent care still sees hundreds of patients daily.
Virtual health visits will likely remain a popular option as the pandemic continues and both patients and doctors experience its advantages, such as saving personal protective equipment, eliminating travel time and keeping social distance.
But because of rapid policy changes due to the health crisis, the costs associated with telehealth may also shift in the coming months. Here's what patients should consider before hopping on a Zoom call with a doctor.
Video is a great tool for follow-up appointments, especially for some post-surgery or primary care, or pre-screening visits, according to Testa.
"Things that are recurrent, or that are 'high talk' and not always so much 'high touch' are great for telehealth because of the convenience," said Testa. In addition, it also gives doctors a new window on patients to be able to view them in their home, which can be helpful for mental health or physical therapy sessions.
A virtual visit may also be the best option for elderly patients who have trouble traveling to a doctor or those worried about contracting Covid-19.
Still, not all conditions are suitable for a Zoom call. If you experience stroke symptoms, a change in mental status or chest pains, it's best to go to an emergency room, he said.
"Telehealth is a great addition to our way of connecting with patients, but ERs aren't going out of business anytime soon," said Testa.
If you're looking to see a doctor virtually for a Covid-19-related visit and have insurance through a major carrier, cost-sharing is likely still waived, but for a limited time. Cigna has waived fees through Oct. 31, while Anthem and UnitedHealth removed them through Dec. 31, reflecting the extended public health state of emergency due to Covid-19.
Fees are likely to apply for telehealth visits not related to Covid-19, especially if you are not on Medicare. Those with Anthem plans, for example, saw a change in coverage in October, when the carrier stopped dismissing fees for telehealth visits except for Covid-19.
Still, coverage and costs will differ. Aetna, which is owned by CVS Health, will continue to waive cost-sharing for some outpatient behavioral and mental health counseling services through the end of the year, the company said. For other visits, costs may apply.
Before making a virtual appointment, there are a few important things to clear up with your insurance carrier, according to Alina Salganicoff, senior vice president and director of women's health policy at the Kaiser Family Foundation.
Patients should determine if the doctor they'd like to see is in-network and confirm what their plan covers in terms of telehealth, as some have different rules for video and telephone visits, Salganicoff said. They should also ask if they'll have a copay for the visit, and how it will count toward their deductible.
"We've always had to do homework before, you know, if we were concerned about costs and particularly if it's a provider that you haven't seen before," said Salganicoff. "Now, given the lack of clarity that both clinicians and insurers often have, I think it's very important to confirm this information ahead of your visit."
Patients should ideally do virtual appointments in a private location where you feel safe and won't be overheard, according to Testa from NYU Langone.
Your doctor may ask sensitive questions about your symptoms or ask to see your body, "so you don't want to be in the middle of the Starbucks," said Testa. He also suggests mounting your camera or phone if you are able.
If you regularly take medication, it's a good idea to have those with you so you can discuss them with your doctor, Testa said. He also said to write down any questions you have beforehand to make sure you get them answered.
"We're so used to the informality of video visits now," he said. "It can be easier to leave the video visit feeling like, 'Oh I didn't get a chance to ask my question.'"
It's also important to understand any next steps following the visit, including if you may need to see a doctor in person if there are any changes to your condition.
"I don't think telehealth should be thought of as standing alone but part of the whole health continuum," said Testa.
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