Seniors, people with chronic medical conditions and their caregivers must be vigilant about minimizing close contact with people who are sick. Even as the expiration dates for COVID-19 stay-at-home orders approach and states prepare plans for reopening, hospitals, doctor’s offices, urgent care centers and other health care settings remain high-risk areas for coronavirus transmission among both patients and medical professionals.
In lieu of in-person visits, experts and health care providers are strongly encouraging Americans to rely on telemedicine tools to seek medical care.
When to Use Telemedicine Services
Telehealth appointments can replace routine visits with primary care physicians, mental health professionals and some specialists. In many cases, a virtual visit can also be used instead of a face-to-face visit at an urgent care center, but telemedicine is not meant to replace acute care for medical emergencies like heart attack, stroke or broken bones. Call 911 for any health issue that requires immediate hands-on medical care or testing (bloodwork, X-rays, etc.) for diagnosis and treatment.
For most seniors, telemedicine can be used for wellness check-ups, follow-up appointments to help manage chronic health conditions, prescription medication refills, colds and flu, and minor infections, such as urinary tract infections (UTIs), sinus infections, and ear infections. The Centers for Disease Control and Prevention (CDC) is even recommending individuals who have mild symptoms of COVID-19 like fever and cough to contact their physician and seek medical guidance via phone or telemedicine since most individuals recover at home without medical care. Of course, if a person begins exhibiting more severe symptoms like difficulty breathing, persistent chest pain or pressure, confusion, inability to rouse, or bluish lips or face, then immediate medical attention is required.
How Do Telehealth Appointments Work?
While seeking medical care via computer or smartphone may seem less than ideal, telehealth tools have been used successfully for decades. The Department of Health and Human Services (DHHS) and the U.S. Department of Veterans Affairs (VA) have long used telemedicine programs to expand health care access for rural and remote communities and veterans respectively.
Virtual doctor’s visits are a lot like normal appointments. If a senior’s regular doctor is offering telemedicine visits, then he or she will already have your loved one’s medical history on file for reference. If a senior has a digital check-up with a new provider, then they should be able to complete their profile on the telehealth platform, including personal information, medical history and current concerns, prior to the appointment. Certain platforms also allow patients to upload pictures to share with the doctor (e.g. images of a rash, bruise or wound) and select a pharmacy to use for any medications the doctor prescribes.
After a virtual visit has been requested, the doctor will review the senior’s health history and connect when they are ready to start the appointment. Seniors and their caregivers should decide in advance how involved the caregiver will be during the actual appointment. Once connected by phone or video conference, the senior, caregiver and physician can discuss the reason for the appointment, symptoms and treatment options.
What Do I Need for Telehealth Services?
Home health care equipment can help doctors who are working remotely make diagnoses, prescribe medications and create care plans for patients. Depending on the reason for a senior’s telehealth visit, it is a good idea to have in-home diagnostic equipment, such as a thermometer, a blood pressure monitor, a heart rate monitor, and a pulse oximeter handy during the appointment. This enables patients to provide physicians with up to date information about their vital signs like body temperature, blood pressure, heart rate and respiratory rate. Doctors can instruct patients on how to take their own measurements without this equipment as well.
Of course, a senior needs an electronic device with certain features and broadband internet access to take full advantage of telehealth services. A video-capable computer, smart phone or tablet is ideal for telemedicine, since it facilitates communication between health care providers and patients and provides doctors with valuable visual information that they cannot gather through a telephone conversation. However, in light of the coronavirus pandemic, the Centers for Medicare and Medicaid Services (CMS) have expanded coverage of telehealth services for Medicare beneficiaries who only have audio phones.
The technological requirements for telemedicine services are likely to be a barrier to access for some seniors, especially since many do not have suitable internet access at home. Although social distancing should still be a top priority for caregivers hoping to protect their aging loved ones, elders may need assistance seeking routine medical care during the coronavirus lockdown. For example, some telehealth programs are accessible directly in web browsers while others may require users to download mobile applications or video platforms to attend virtual appointments. Fortunately, a simple Google search will yield resources online that provide free technology training and tutorials for seniors who need help.
In addition to scheduling and attending virtual appointments, access to technology can enable seniors to arrange for shipment or contactless delivery of prescription medications, groceries and other household supplies to further minimize their risk of getting sick. Videoconferencing applications and programs are great for combatting loneliness and helping seniors stay connected with friends and family while social distancing as well.
How Much Does a Virtual Doctor’s Appointment Cost?
Another benefit of telemedicine is that remote appointments are often cheaper compared to in-person medical visits. A 2017 study found that the average cost of a telehealth visit was $79, although virtual mental health appointments with psychologists and psychiatrists tend to be more expensive.
Medicare only covered telehealth services in certain circumstances prior to the COVID-19 pandemic, but that has changed for the time being. In March, CMS temporarily expanded Medicare telehealth coverage for all beneficiaries to ensure seniors get the care they need while sheltering in place.
According to a CMS press release, Medicare telehealth visits, virtual check-ins and e-visits are covered for all Medicare Part B beneficiaries for the duration of the COVID-19 Public Health Emergency. Telehealth visits are considered the same as in-person visits and are billed as such, but seniors can receive these services in the safety of their homes, including nursing homes and assisted living facilities. Medicare coinsurance and deductibles still apply, but “the HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.”
Some Medicare Advantage Plans (Part C) may now offer more telehealth services than were originally included in their listed 2020 benefits. Furthermore, private insurance companies like Aetna, Blue Cross Blue Shield, Humana and UnitedHealthcare have expanded access to telehealth services for their members and/or waived cost-sharing payments for virtual visits.
CMS has also encouraged states to expand the use of telemedicine services to deliver care to Medicaid beneficiaries. However, coverage differs by state, so it is important to check with your state’s Medicaid program to learn how to access virtual doctor’s appointments.
Uninsured individuals can take advantage of telemedicine services during the lockdown as well. There are several private-pay telehealth providers that offer virtual visits for a flat fee. Popular providers like Teladoc, Doctor On Demand and AmWell provide 24/7 access to online appointments with physicians, mental health professionals and even specialists like dermatologists.
How to Schedule a Telemedicine Appointment
To get started, contact a senior’s physician(s) directly to ask if they already have a telehealth program in place. If so, you can rely on their system for routine care and follow-up appointments during normal business hours. For those who require urgent care and those whose doctors do not use telemedicine, check with your insurance company to see what coverage options they offer. Many commercial health insurers provide some sort of telehealth benefit to their members, usually through a specific platform.
Telehealth appointments are ideal for busy caregivers and seniors now and after the coronavirus lockdown ends. It is wise to investigate a senior’s telehealth options and set up their profile (if necessary) before the need arises. This will ensure that they have immediate access to expert medical advice without having to download a software program or enter their health history while they are not feeling well.
The current trend toward increased access to telemedicine bodes well for the future of senior care. Virtual check-ups eliminate the need to drive to doctors’ offices, reduce the amount of time spent sitting in waiting rooms, and minimize your and your loved one’s exposure to illnesses like COVID-19, the flu and the common cold. Taking advantage of these services helps safeguard our aging loved ones, ourselves and our communities as a whole.
Sources: What to Do If You Are Sick (https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html#warning-signs); Additional Background: Sweeping Regulatory Changes to Help U.S. Healthcare System Address COVID-19 Patient Surge (https://www.cms.gov/newsroom/fact-sheets/additional-backgroundsweeping-regulatory-changes-help-us-healthcare-system-address-covid-19-patient); Direct-To-Consumer Telehealth May Increase Access To Care But Does Not Decrease Spending (https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.1130); MEDICARE TELEMEDICINE HEALTH CARE PROVIDER FACT SHEET (https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet); Telehealth Insurance Coverage (https://www.medicare.gov/coverage/telehealth); Medicaid State Plan Fee-for-Service Payments for Services Delivered Via Telehealth (https://www.medicaid.gov/medicaid/benefits/downloads/medicaid-telehealth-services.pdf); Health Insurance Providers Respond to Coronavirus (COVID-19) (https://www.ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19/)