En español | Veterans and members of the military have always had access to telemedicine, but their use of virtual visits has exploded since the pandemic began. Here are the services covered by the Veterans Health Administration and Tricare health plans:
Mental health and loaner tablets: A look at what the VA covers
The VA has offered telemedicine services through its Video Connect platform since 2017. Since the pandemic began, there's been a more than 1,000 percent growth in telemedicine encounters, says Kevin Galpin, M.D., executive director of VA Telehealth Services. Currently, veterans engage in about 32,000 video visits per day.
Patients receive several different types of care via telemedicine — mental health, physical therapy, audiology, routine physicals and medication management for diabetes and high blood pressure. There have been 1.5 million mental health visits this year — a more than 80 percent increase over last year. The most common diagnosis is post-traumatic stress disorder; other reasons for mental health visits include depression and anxiety. The VA also offers remote patient monitoring services via telemedicine, which has been especially helpful for patients with COVID-19 symptoms.
VA providers can offer any type of health care via telemedicine “as long as the doctor feels it's clinically appropriate,” says Galpin. There's no copay for those who are enrolled in VA services, but patients may still need to meet a deductible.
The VA has facilitated access to telemedicine by lending more than 45,000 cellular-enabled iPads to veterans who don't own digital devices. “Veterans overwhelmingly prefer video over phone,” says Galpin. “They have told us that using the devices helps them save time and money.” By the end of 2021, the VA plans to make all outpatient specialty services — including cardiology, endocrinology and rheumatology — available to patients via telemedicine.
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Audio visits and authorized providers: A look at what Tricare covers
Since the pandemic began, there have been more than 1 million telemedicine visits through Tricare. In May, Tricare made several changes to increase access to telemedicine. It began to cover audio visits, allowed doctors to treat patients in states in which they aren't licensed to practice, and waived copays and cost sharing for all covered, in-network services. These changes are expected to remain in place until the public health emergency is over.
During the pandemic, more than half of Tricare's telemedicine visits were related to behavioral health problems, such as anxiety, depression and post-traumatic stress disorder.
Patients have access to a variety of primary care, urgent care and behavioral health telemedicine services, which are reimbursed at the same rates as in-person visits. This includes treatment for illnesses and injuries, as well as post-surgery follow-up visits. As long as an illness or injury can be safely evaluated through a virtual visit, it's covered, says Capt. Edward Simmer, M.D., chief medical officer at Tricare. “We think the use of primary care and behavioral health telemedicine services will continue to increase significantly,” he says. Simmer also sees more follow-up visits for chronic conditions, such as diabetes and high blood pressure, continuing.
Patients must use Tricare-authorized providers to access telemedicine services. Tricare doesn't provide telemedicine services to members directly, though. In the East, Tricare partners with Humana and Doctor on Demand, which offers urgent care and behavioral health services. In the West, Tricare works with Health Net, which has a network of providers. Telemedicine is also available for members who are stationed overseas. (Tricare adheres to the host nation's requirements for virtual visits.) “We've made it easier for patients to get the care they need when they need it,” says Simmer.