With experts urging telemedicine to get direction on early symptoms during the COVID-19 pandemic, one productive way to pass some time while staying home is to set up a telehealth account while you’re still feeling well. Or, thanks to a major change in HIPAA regulations announced Tuesday, if you’re a Medicare patient, get familiar with a videochat app like Skype or Facetime to speak with your own physician without going to the office.
Even Medicaid patients may be able use telehealth with their own doctors, if states follow the advice of the federal coronavirus task force. The changes, initiated by Congress, are intended to help older people avoid doctors’ offices during the pandemic. Telehealth is also going to be covered for virtual visits for ongoing medical problems like diabetes.
Beyond Medicare and Medicaid, virtual visits outside of a patient’s own physicians are available through the websites of many insurance providers, including Aetna, United Healthcare and Florida Blue. Telehealth is also available through the CVS website, available 24/7 for $59. There was only a 20-minute wait on the site Monday, but patients need to set up an account, which takes some time and might be best done when people are feeling clear-headed and symptom-free.
Cleveland Clinic also has a 24/7 telehealth initiative, Express Care Online. “They’ve really ramped up the staffing for that service,” said spokeswoman Angela Dickens.
Setting up an account for any telehealth can involve downloading an app on a smartphone or other mobile device. Information about insurance and medical history may be required. Typically, sign-up takes about 10 to 20 minutes. The patient can then make an appointment for a visit, or wait on the spot for one to open up; a sampling earlier this week showed online waits between 10 and 20 minutes. When a patient with flu-like symptoms dials into the virtual visit from a computer or other device, a doctor will appear on the screen to walk the patient through a list of questions to try to rule out flu or allergies, and determine if the patient needs a higher level of care. But that’s just a first step; they are not able to definitively diagnose or treat COVID-19 disease.
At that point, according to Dickens, the patient would be directed to call their primary care physician or the county health department, which directs callers to its epidemiology department. Driving straight to any clinic or hospital is not recommended without prior notification so medical personnel can gear up for your arrival.
Whether a patient is then directed to get a test is up to the health practitioner. As of Monday, the CDC guidelines for testing no longer required travel or exposure to an infected person as a criterion for testing.
If the doctor recommends the patient be tested, a foray into the outside world will almost certainly be required. In St. Lucie County, besides getting swabbed at the Health Department on Avenue C in Fort Pierce and on Milner Drive in Port St. Lucie, drive-through testing should be available soon in the parking lots of Wal-Marts, as announced last weekend. And Cleveland Clinic’s Tradition Hospital is planning to offer drive-through testing by today (March 20), as it already does in Martin County.
In some cases, certain COVID-19 symptoms do require immediate medical attention. The CDC has recently added a warning on its website for “emergency warning signs” including difficulty breathing or shortness of breath, persistent pain or pressure in the chest, lips turning blue, confusion that is new or an inability to arouse.
As for paying for the virtual visits, most commercial insurance plans cover them now, and some have even waived copays during the COVID-19 crisis.
Medicare too should be covering those costs, though it has been slow to get on board with telehealth.
Congress’s COVID-19 appropriations bill last week gave the Health and Human Services secretary the ability to waive certain Medicare rules on telehealth reimbursement that essentially limit telehealth to rural patients, and require the patient to “originate” the visit in a hospital or doctor’s office, and not at home. Prior to those barriers being lifted by the congressional action, Medicare required that the virtual visit doctor, or a doctor in the same practice, have treated the patient in the past three years.
Beginning this year, Medicare Advantage plans typically cover more telehealth services than original Medicare, including allowing visits from home – where possible COVID-19 patients need to stay.
And while you’re stocking up on supplies for COVID-19 cocooning, don’t forget to buy a thermometer. Your virtual doc can’t take your temperature and fever is the most common symptom caused by the new coronavirus.