Medicare & Telehealth in Decatur, Illinois

When COVID-19 became a Public Health Emergency in early 2020, the Centers for Medicare & Medicaid Services (CMS) immediately expanded its telehealth coverage.

Telehealth, or telemedicine, is not only convenient, but it’s been a great way to get care during the pandemic.

What Is Telehealth?

Telehealth is just like a regular in-office appointment, but it’s done from home using two-way, real-time audio and video technology. The doctor needs to see and hear you – and vice versa – for your visit to be a proper telehealth visit.

Medicare telehealth services include:

• Office visits
• Psychotherapy
• Consultations
• Other certain medical or health services

Shorter communications with your physician that don’t need video capabilities are also covered by Medicare now. These are called virtual check-ins and e-visits.

• Virtual check-ins allow you to talk to your physician briefly through a phone call, text message, email, or a patient portal.
• E-visits allow you to talk to your doctor using an online patient portal.

The nuances are mainly for your providers so they can use the correct billing codes with Medicare. What’s important is you can get certain types of care from home, a major convenience!

Medicare Advantage and Telehealth

As of 2020, Medicare Advantage plans may offer more telehealth services than ever before (Medicare.gov).  

Today, most Medicare Advantage plans include telehealth benefits, including one of our top picks in Macon County for 2021, the Aetna Medicare Value Advantra PPO.

For example, this Aetna PPO plan allows policyholders to receive primary and urgent care services via a virtual visit for the same cost as an in-person visit, typically a $5 copay with your PCP or $40 for urgent care. During the COVID-19 Public Health Emergency, telehealth visits with network PCPs have a $0 cost-share.

Plus, depending on your location, you would have 24/7 access to MinuteClinic® Video Visits.

Read more about our analysis of Medicare Advantage plans in Decatur, IL.

What You Need for a Telehealth Visit

There is some technology involved to visit with your physician virtually. The exact instructions and setup will vary depending on what platform your physician uses.

For example, many hospitals and doctor’s offices use Microsoft Teams (including DMH in Decatur, IL!).

In that case, you will need to download the Microsoft Teams app on your smartphone. Your physician will email you a link to join the meeting, and you’d access the meeting by clicking it. You’d enter the visit as a guest, so you don’t need to worry about creating an account.

You can also do telehealth from a laptop or computer, typically by clicking a meeting link sent to you by your provider.

Other physicians use a technology called VSee that allows you to access a “waiting room,” similar to waiting in a physical office.

You click the link to join your provider’s waiting room and enter your name and address. Then, your session is set up, and your provider connects. VSee is the technology LifeStance Health – a counseling company with a Decatur, IL location, uses to offer telehealth services.  

Providers in Decatur, IL and Telehealth Visits

Before the pandemic, many hospitals and physicians were beginning to offer telehealth options when you don’t need to go to the office. However, the COVID-19 pandemic sped up that transition, and today, most providers have telehealth capabilities.

According to Amwell’s 2020 Physician and Consumer Survey, the percentage of physicians using telehealth spiked from 22% in 2019 to 80% in 2020.

If you’re interested in providers who offer telehealth in Macon County, we found a few that mention telehealth options on their websites. Most notably, DMH and St. Mary’s have telehealth capabilities, so if your doctor or physician is in that hospital network, you likely have access to telemedicine.

Hospitals

• Decatur Memorial Hospital (DMH) offers telehealth visits via Microsoft Teams.
• HSHS Medical Group (St. Mary’s) offers telehealth visits via Anytime Care.

Mental Health (Counseling, Therapy)

• LifeStance Health (formerly Edgewood) offers telehealth visits via waiting room technology.

Urgent Care

• Memorial Physician Services offers telehealth visits via their Memorial app.

You can also search doctors by specialty and filter them by which ones offer telehealth on Sharecare’s website.

For example, I can search for dermatologists in Decatur, IL and surrounding areas and filter by telehealth. There are 32 dermatologists within 100 miles in Decatur, IL who offer telehealth.

‍

You can also call your favorite doctors and ask if they offer telehealth options or virtual check-ins.

Telehealth Limitations

Telehealth is excellent not only for reducing your COVID-19 exposure risks but it’s also convenient. You can get care right from your couch – no driving, parking, or waiting rooms required.

If you have questions or need advice, that’s where telehealth shines. You and your doctor can easily do these types of appointments over the phone.

However, there are limitations. Sometimes, your doctor needs to do a physical valuation that’s just not possible to do virtually.  

Here are some examples of appointments you can’t do properly with telehealth:

• Patients with preexisting conditions that have developed new, worsening symptoms
• Any appointment requiring a physical examination
• Patients who need a formal assessment before treatment
• In-office therapies, treatments, or shots

No matter your situation, you have the right to ask if telehealth is an option. Some doctors triage their patients over a video conference or phone call before deciding if they need to come into the office. It never hurts to ask.

Telehealth and Medicare Costs

Medicare part B covers certain telehealth services, but you are still responsible for the 20% coinsurance and your Part B deductible.

If you have a Medicare Supplement Plan F, you have no costs for telehealth services approved by Medicare.

If you have a Medicare Supplement Plan G, the 20% coinsurance is covered in full, but you are responsible for your $203 deductible in 2021.

If you have a different Medicare plan and have questions about your telehealth costs, give us a call at 217-423-8000 or contact us online. Our licensed agents can help!

Conclusion

Telehealth is a great option, especially as we navigate the COVID-19 pandemic. If you have a Medicare Supplement, your costs for telehealth services with be minimal or even no-cost.

If you have a Medicare Advantage plan, your plan might include a special telehealth benefit that allows you to receive these services at no cost to you.

For any questions related to Medicare coverage, call us at 217-423-8000, fill out our contact form, or start a live chat!