Telemedicine has become a hot trend among insurance carriers and consumers. It’s not surprising since most services are now available online, so why not healthcare too? 

Telemedicine allows individuals to access a board certified and licensed physicians via phone, email or video chat - 24 hours a day and 7 days week - for common illnesses such as sore throats, UTI, allergies, common cold, eye infections, earaches and more. These doctors can diagnose and prescribe medication that the individual can pick up same-day.  

While many agree this is a great benefit, the question now is should you use a telemedicine benefit that is incorporated into your medical coverage, or should you purchase a stand-alone service?  Insurance carriers are finding that this benefit is keeping individuals out of urgent care and emergency rooms, which impacts medical plan claims utilization and ultimately, premium costs. For these reasons, several insurance carriers are now offering telemedicine as an included benefit within the standard medical plan design and coverage at a very low cost, or even no additional cost. 

It is important to know that there are advantages and disadvantages of utilizing a telemedicine benefit that is incorporated with your medical plan versus a stand-alone service. 

Advantages of Telemedicine included on Medical Plan

• Individuals do not have to keep track of two separate benefits plans and cards
• Small or even no additional premium costs or upfront fee to the employer 
• Treatment may report directly to your electronic health record for your PCP to review
• Reporting availability for utilization purposes (some stand-alone services offer as well)

Disadvantages of Telemedicine included on Medical Plan

• Treatment costs likely contribute to medical plan claims and overall plan utilization
• Individuals are usually required to pay office visit copays or deductible (several stand-alone telemedicine vendors offer consultation services at no cost to the employee which improves utilization)
• Limited technology as carriers may only offer one or two options among phone/email/video chats but maybe not all options, and likely does not include alerts tied to geo-fencing capabilities which can identify when a member is in an Emergency Room and re-direct them
• Must be enrolled on medical plan to access telemedicine if going through carrier
• May be limited to providers within carrier network and therefore, potential longer wait times for in-network physician availability

Whether or not telemedicine is embedded in your medical plan or offered separately, it is quickly becoming an essential benefit in any group medical benefits package. Many vendors have designed mobile apps that have made this benefit a first stop for medical care and it’s a smart choice for savvy healthcare consumers. 

For more information about your current carrier’s telemedicine offering, or if you are interested in learning more about telemedicine, please contact your Fall River Account Executive or This email address is being protected from spambots. You need JavaScript enabled to view it.