Written on November 29, 2022 by Theresa Vuskovich, DMD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
Table of contents
During the COVID-19 pandemic, telehealth claims increased by 4,347% between March 2019 and March 2020 [1]. Due to telehealth's popularity during the pandemic, public and private health insurance companies now cover telehealth services. However, coverage (i.e., payment) varies across plans.
This article explains the basics of telehealth, telehealth insurance, and coverage for Everlywell's virtual visits.
Telehealth is "the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration" [2]. On the other hand, telemedicine involves interaction between a patient and a clinician who are physically separated [9]. Although these definitions seem similar, there are subtle differences, such as telehealth encompassing a greater range of services [9]. Telehealth appointments offer patients remote clinical services through a variety of technologies. These include video platforms, text messaging, telephone calls, or a healthcare provider's online portal.
The concept of telehealth originated in the 1970s with the "Fathers of Telemedicine," Dr. Rashid Bashshur and Dr. Jay Sanders [4]. After the 2008 recession, the American Recovery and Reinvestment Act directed over $25 billion to advance digital healthcare and technology [4]. Even though office visits have increased following the COVID-19 pandemic, telehealth appointments are still popular due to their convenience and the variety of services available [4,9].
Telehealth appointments can help you access a wide range of healthcare services: [3, 7, 8, 11,12]
Before making an appointment, check with your healthcare provider or insurance company to determine if your insurance covers the services.
Telehealth appointments are ideal for managing prescriptions since many chronically ill patients need to schedule regular appointments with their healthcare providers [2]. Telehealth appointments make it easier for patients to access medication and adhere to medication schedules. Since state prescribing laws vary, you should also ask your healthcare provider's office what medication they can prescribe during a telehealth appointment [2,5].
Aside from offering convenient access to care, telehealth appointments lessen the burden on the medical system by reducing staffing and facility needs [2,12]. Additionally, telehealth appointments can protect you from infectious diseases and prevent others from getting sick if you are ill [2,12].
Now that you understand the basics of telehealth appointments, let's look at health insurance coverage for telehealth visits. Telehealth coverage increased thanks to COVID-19, which prompted more public and private health plans to cover virtual visits.
Medicaid coverage for telehealth services is based on your state. You can contact your local Medicaid program to see if telehealth services are covered.
Before COVID, Medicare covered about 100 telehealth services, such as office visits, psychotherapy, and preventive health screenings [6]. As a result of COVID, Medicare now covers a wider range of telehealth services. Behavioral health and patient education are covered through video platforms or by audio-only telephone [6].
Similar to Medicaid, private health insurance coverage varies widely. For more information about your telehealth coverage, you can visit your insurer's website, which frequently provides an overview of your benefits. You can also determine your eligibility by contacting your healthcare insurance company or healthcare provider.
You can still use telehealth services even if you don't have health insurance. However, you will have to pay out-of-pocket for your services.
Everlywell offers virtual visits to assess the symptoms you are experiencing and provide you with the proper tests, prescriptions, and lifestyle recommendations. You will meet with a licensed nurse practitioner for 20 to 30 minutes through a virtual platform. Before you schedule your virtual care visit with Everlywell, here's what you need to know about insurance coverage:
You can confirm coverage by scheduling your visit and entering your insurance information if you have private health insurance. Once you have scheduled an appointment, Everlywell's partner, OpenLoop, will send you an email with a summary of your eligibility and costs.
It's important to understand your insurance as well as situations where Everlywell telehealth is not right for you. These situations include being 18 years or younger and seeking any of the following:
Everlywell's telehealth program offers convenient, equitable healthcare options to individuals with and without insurance. Visit Everlywell's online booking service to schedule your first appointment and determine your coverage eligibility.
Everlywell makes lab testing easy and convenient with at-home collection and digital results in days. Learn More
