Virtual Doctor Visits Are Getting More Popular, but Questions Remain About Who Pays

The new federal budget law lets Medicare cover telemedicine services for people who have had a stroke and those who receive kidney dialysis, while also allowing Medicare Advantage plans to offer telemedicine as a covered benefit, reports the Washington Post . Meanwhile, as of Jan. 1, Medicare began permitting doctors to bill the government for monitoring certain individuals remotely using telemedicine tools. Some telehealth e-visits are covered by private health plans, Medicare, state Medicaid programs, and the Department of Veterans Affairs, while more health centers and hospitals are rolling out virtual health centers and websites offering virtual "doctor-on-demand" services are spreading. However, physicians worry that they may receive less remuneration if insurance reimbursement is lower for e-visits than for in-person appointments, or that e-visits could reduce face time. In addition, health economists are concerned that e-visits could increase costs. Most telehealth e-visits are for primary care or follow-up services, although a growing number are for people with chronic conditions who are being monitored at home. Overall, e-visits are less expensive than a trip to the doctor, but care beneficiaries may not see the difference if their insurance covers both with only a small co-pay or no co-pay. For people with large deductibles, an e-visit may mean they pay less out-of-pocket for that session.