Everyone’s been told to stay home as much as possible to stop the spread of the novel coronavirus. For many Medicare enrollees, the threat is especially high because older people and people with underlying health conditions may be more likely to experiencing severe cases of COVID-19. This can make taking care of essential tasks difficult, but the modern world offers some solutions. For groceries and other supplies, there are deliveries. For health care, there’s telemedicine.
Recent rule changes have expanded telehealth options for Medicare enrollees.
Expansion of Telehealth Benefits
Original Medicare provides limited telehealth benefits, virtual check-ins and e-visits. However, access to some benefits may be restricted to beneficiaries who live in rural areas and are receiving care from medical facilities.
Some Medicare enrollees have broader telehealth benefits, however. This is because Medicare Advantage plans can offer additional telehealth benefits, and recent rule changes make this easier.
In April 2019, CMS announced a rule change that allowed Medicare Advantage plans to offer additional telehealth benefits starting in plan year 2020. According to the fact sheet, Medicare Advantage plans were already able to offer some supplemental telehealth benefits, but the new final rule allowed plans to expand access to telehealth services whether enrollees live in rural or urban areas. The rule also means that Medicare Advantage enrollees can receive telehealth services from their home instead of having to go to a healthcare facility.
Temporary Expansion of Telehealth Benefits in Response to COVID-19
In response to COVID-19, Medicare has temporarily expanded its telehealth benefit offerings.
During the coronavirus crisis, people enrolled in Original Medicare have access to expanded telehealth services that include office visits, mental health counseling and preventative health screenings. The services can be accessed from the beneficiary’s home, and the cost-sharing may be waived.
The Advantages and Limitations of Telehealth and Telehealth Benefits
Telemedicine is not always an appropriate option. In some cases, a face-to-face visit may be needed for proper diagnosis and testing.
However, for patients who live in rural areas or who have mobility issues, telehealth services can increase access to care. Telemedicine may also be less expensive than other care options. According to research published in the American Journal of Emergency Medicine, telemedicine consultations can provide short-term cost-savings, and each telemedicine visit resulted in net cost savings of $19 to $121.
Tell Your Clients About Telehealth Options
Make sure your clients know about their telehealth options.
If your clients are enrolled in Medicare Advantage, they should check with their plans to see what benefits are available. If they are enrolled in Original Medicare, they may be able to take advantage of expanded telehealth benefits during the coronavirus crisis. If your clients think they need a telehealth visit, they should contact their health care provider for information on setting up an appointment and associated copays.