Telemedicine and Telemedicine
Getting sick during a pandemic can be a source of anxiety. If you develop symptoms, you will want to be evaluated to make sure you are not infected and to get the care you need when you need it. Some people may have chronic illnesses or transportation problems that make it difficult to get to an emergency room, urgent care clinic, or doctor’s office. Also, it may be risky to enter a waiting room full of people where the disease could spread to others or vice versa.
This is where telemedicine, also known as telemedicine, can help. These types of visits allow healthcare professionals and patients to talk to each other in real-time using video conferencing. This can be done online or via mobile apps using HIPAA-compliant healthcare software.
Medicare Advantage plans were authorized to add telemedicine as an optional supplemental benefit in 2019. Original Medicare also covers telemedicine visits but limits who can use it. The service is available to people living in qualified rural areas and who are at designated medical sites (eg visits are not covered from home), people needing stroke assessments regardless of their location, and people who have end-stage kidney disease and receive home dialysis treatment.
Even without this extended coverage, a telemedicine visit usually costs less than an office visit. The goal is to keep you at home whenever possible to reduce the risk of being exposed to COVID-19 in the community.
Qualified hospitals and nursing facilities
People living in rural areas may not live near health facilities. The Medicare Rural Hospital Flexibility Program has helped increase access to care by allowing certified critical access (CAH) hospitals to open in those areas of need. These hospitals are smaller in size than traditional hospitals, but must have first aid. A CAH is limited to having 25 inpatient beds and is not allowed to have hospital stays longer than 96 hours. In response to the COVID-19 pandemic, however, CMS has waived restrictions on CAHs so they can accommodate more patients and extend their stays as needed.
Medicare will also continue to pay for medically necessary stays in a traditional hospital. That being the case, the two-midnight rule still applies. This means that you will be placed under observation (where Part B covers your stay) or hospitalized as an inpatient (where Part A covers your stay) based on how sick you are, the intensity of services you receive, and how long you should stay in the hospital.
Traditionally, Medicare requires a hospital stay that lasts at least three days before covering a stay in a Qualified Nursing Facility (SNF) or nursing home. Medicare Advantage plans had the option to waive this rule, but now CMS allows Original Medicare to waive this rule as well. If there are increases in COVID-19 cases, hospitals can peak in capacity. To care for the sickest people, some patients may need to be diverted to other locations, including CAH or SNF, as they recover or are being treated for less severe conditions.