Medicaid, Telemedicine and You - Improving Health Care Access

Using Nontraditional Medical Visits

Medicaid covers telemedicine
Medicaid is encouraging use of telemedicine. Joshua Hodge Photography/E+/Getty Images

You cannot always be seen in the doctors office. It could be you are homebound or do not have a means of transportation. It could be that your doctor does not have availability for a same-day appointment. Whatever the reason, it would be nice to know you could get one-on-one time with your doctor in another way.

What is Telemedicine?

Telemedicine is more than calling your doctor on the phone for a refill or asking him a question about your lab tests.

Telemedicine is video conferencing with your doctor as if you were in an exam room. You both see and hear each other. Think about it as a face-to-face visit from a distance.

Advances in technology have made this service possible over the years. For areas with doctor shortages or in rural communities, telemedicine can make a real impact on healthcare access.

Advantages of Telemedicine

Telemedicine has obvious advantages.

  1. It is convenient to have your visit from the location of your choice.
  2. Telemedicine decreases waiting room times.
  3. Since you can do it from anywhere, telemedicine could decrease the amount of time you would need to take off from work.
  4. Telemedicine may allow continuity of care with doctors that know you.
  5. You may be able to access doctors and specialists you would not otherwise be able to see due to the need to travel long distances.
  6. Telemedicine is cheaper than going to an urgent care clinic or emergency room for minor issues.

    Disadvantages of Telemedicine

    When you teleconference with your doctor, you must realize there are limitations. Not all doctors are currently set up for the service. Your doctor cannot simply use Skype or Facetime to make this work.  Their equipment needs to be HIPAA compliant to know that your information is secure.

    Your doctor is also working on limited information during these "visits". Though he can hear your cough, he cannot listen to your lungs. Though you can describe your chest pain, he cannot listen to your heart or feel your pulse. Unless you have access to medical equipment at home, he cannot check simple vital signs such as blood pressure.

    The ability to make a definitive diagnosis or to offer treatments in certain situations will not be possible. However, telemedicine could be an important tool for your doctor to guide your care, whether that is to offer treatment options, schedule an in-person visit or direct you to the nearest emergency room.

    Telemedicine Differences Between Medicare and Medicaid 

    It is interesting that the Centers for Medicare and Medicaid has different viewpoints on telemedicine when it comes to Medicare and Medicaid, at least for now. There are strict restrictions put on Medicare beneficiaries. First, Medicare beneficiaries must live in qualifying rural communities. Next, they must be located in a healthcare facility (community mental health center, dialysis center, doctor's office, health clinic, hospital or skilled nursing facility) and cannot access the service from home.

    This significantly limits telemedicine's usefulness to the Medicare population.

    On the contrary, Medicaid services may have broader access to telemedicine services according to a new ruling. The federal government wants each state to offer a basic telemedicine service and to assess the performance of that service every three years. This ruling would also allow patients to access care across state lines. Since Medicaid is state-run, each state may implement the ruling differently according to their State Practice Act. The ruling will not affect patient care until July 2016. 


    42 CFR Part 447 Medicaid Program; Methods for Assuring Access to Covered Medicaid Services; Final Rule. Federal Register. 2015 November 2; 80(211).

    Continue Reading