Telemedicine may have existed for decades now in one form or another, but it is only in recent years that it has become more popular as well as necessary. More specifically, the outbreak of the COVID-19 pandemic has made it essential for patients and caregivers to access medical help and consultation from the safety and comfort of their homes.
Many individuals are preferring to consult with medical professionals online rather than head out to a clinic or a hospital. This, coupled with many medical helplines and online consultation platforms, have made telemedicine more popular in recent times. Even services like diagnostics can be rendered partially remotely, with service booking as well as report and result delivery being made possible via online platforms or mobile apps.
The rising prevalence of telemedicine may lead to a few very pertinent questions - Are telehealth visits covered by insurance? And if they are, for how long will insurance companies cover telehealth?
To understand this, let us first decode what telemedicine is and how it works.
Telemedicine is simply the delivery of medical and healthcare services remotely, using information and communication technology. This is particularly useful in case distance is a key factor, or in case a patient needs emergency medical consultation but is unable to make a physical visit to the doctor’s clinic or a hospital.
Telemedicine can be used for diagnosis, treatment, care and monitoring of health conditions. It works in different ways and can be carried out for different purposes. Video consultations, remote medical diagnosis, medical imaging and online evaluations are all examples of telemedicine. It works on a simple enough principle wherein you can access medical services online, just like how you can avail many other services remotely these days.
You can check out the different medical practitioners listed on telemedicine platforms under the specialty related to your problem, fix an appointment with the doctor and connect with them over chat, phone or video, as per your convenience. Based on your symptoms, doctors may prescribe diagnostic tests, which can also be booked online. The results for the same can also be mailed to you, and you can share them with your doctor, who will likely prescribe medicines as needed. And lastly, you can even purchase these medicines online, thereby bringing the circle of telemedicine full circle.
Telemedicine has been particularly relevant during the pandemic. Recognising this fact, the Insurance Regulatory and Development Authority of India allowed for a major relaxation back in October 2020, according to which telemedicine will be covered under health insurance plans. As per this IRDAI release, any expenses that a health insurance policyholder incurs for telemedicine can be claimed under the insurance plan, provided the policy already offers coverage for outpatient department (OPD) expenses.
Similarly, if you purchase a new health insurance plan that covers OPD costs, then it automatically brings telemedicine under the coverage offered by the policy. This is a welcome move that helps individuals access quality medical care without exposing themselves to the virus during the pandemic and without worrying about the financial burden of the medical bills, since telemedicine is also covered under existing policies that cover OPD costs.
To check if you are eligible to claim telemedicine costs from your health insurance provider, you can check if your health insurance policy covers outpatient costs. In case it does, you can rely on the relaxation offered by the IRDAI to enjoy telemedical services without tapping into your savings to pay for the costs.
You can go through your policy document and check if telemedicine and telehealth therapy are covered by insurance. Alternatively, you can also check with your insurer directly by calling them or writing to them.
The IRDAI has not specified any deadline or end date up to which telemedicine will be covered by health insurance plans. So, if you are wondering how long insurance companies will cover telehealth, you can rest assured that as of now, there is no end date mentioned for this benefit.
Owing to the necessity for limited physical contact during the COVID-19 pandemic, coupled with the convenience and the need to consult doctors online, the IRDAI has asked insurers to cover telehealth visits under existing health insurance plans.
No, you do not have to pay any additional premium for telemedicine coverage, since the IRDAI has asked insurers to cover these services under existing plans that offer coverage for outpatient department (OPD) expenses.
Yes, it will cover telemedicine since the IRDAI has notified health insurance providers to include such services, provided the health insurance plan covers OPD expenses.