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4:13 PM, Feb 27, 2020

Coronavirus

4:13 PM, Feb 27, 2020

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How to get a house call from the doctor during COVID-19 pandemic

Posted at 8:27 AM, Apr 17, 2020
and last updated 2020-04-17 14:41:45-04

If you’re not feeling well and want to see a doctor, you may be concerned that going to a physician’s office, an urgent care facility , or a hospital could expose you to the coronavirus disease COVID-19.

“People are understandably worried that they are going to get sick if they go to the doctor,” says Ateev Mehrotra, M.D., an associate professor of healthcare policy at Harvard Medical School who conducts research on the use of telemedicine to improve healthcare. “This is a situation where going to get care can put you more at risk, and people may want to seek other options.”

In fact, there are now a host of options for non-emergency care in your own home, from on-demand house calls you request through an app to telemedicine services, such as virtual doctor visits via smartphone or computer. Some services will diagnose you via video consultation, then determine whether you need to see an in-person provider at home.

Telemedicine can also be as simple as emails or phone calls with your regular doctor or having a healthcare provider email you a treatment plan based on your answers to a symptom questionnaire you fill out online, Mehrotra says.

Getting care at home, at least initially, is exactly what health officials want you to do now, too. The World Health Organization and the Centers for Disease Control and Prevention are calling for hospital and healthcare providers to increase the use of telehealth services to ease pressure on healthcare facilities, reduce exposure risks for those who don’t have the virus, and treat people who are quarantined at home.

Home care is appropriate even for people diagnosed with COVID-19, according to the CDC, because the majority are only mildly ill and can manage their symptoms at home. And the new $8.3 billion spending package to combat COVID-19, signed this morning by President Donald Trump, includes $500 million for Medicare providers to administer telehealth services to elderly patients, who are at higher risk for the disease.

If you’re considering seeking at-home healthcare, here’s what you need to know.

With healthcare at home, you’ll receive care from a medical doctor, physician assistant, nurse practitioner , or nurse, depending on your particular health concerns. House call and telemedicine services are generally used for issues such as minor burns and cuts, conjunctivitis, back strains, rashes, flu , and urinary tract infections. House call providers can also help people manage chronic conditions like high blood pressure and provide preventive care such as vaccines.

Many of these services are covered by insurance. Of course, you may still have copays, coinsurance, or deductibles, but some fees, like copays, may be lower than those for in-person doctor’s visits. And if you don’t have insurance, you may be able to choose from a menu of services with flat fees, which run from about $50 to $200, depending on your medical needs.

Your regular doctor. Even though only a quarter of doctors say they’re using tools like video visits, according to a recent survey by the American Medical Association, many communicate with patients via email and telephone, especially for follow-up care.

Even if your doctors don’t typically use telemedicine, they may start using it now or be employing it in the near future: An additional 20 percent of physicians says they are planning to adopt telemedicine within the next year, according to the AMA survey.

5 Ways to Get Healthcare at Home

Your health insurer. You may have access to at-home healthcare through your health insurance. Nearly 9 out of 10 employers with 500 or more workers that provide health insurance have a telemedicine program.

Insurers typically partner with outside vendors such as Teladoc Health, a network of primary care physicians who diagnose routine, non-emergency medical problems via the telephone or video. They can also prescribe medications, send your records to your regular doctor, and make referrals, and are available around the clock seven days a week.

Right now, Teladoc and other telehealth companies are touting themselves as a first stop for coronavirus information, and sometimes other resources as well. Amwell, another telemedicine company that often works with employers and health insurance plans, for instance, now has an infection control officer on call at all times.

Without insurance, many of these telemedicine services charge a flat fee. Amwell, for example, charges $69 for an online urgent care visit and can provide prescriptions and recommendations for in-person follow-ups with specialists. MDLive urgent care consultations are $75 without insurance.

Local urgent care and walk-in retail clinics. An increasing number of these kinds of facilities, which may be freestanding or located in or next to chain pharmacies or big box stores, are offering video consults that allow you to get in touch with a healthcare provider quickly.

CVS, for example, which operates more than 1,000 MinuteClinic inside its stores, has video visits 24/7 for $59. These visits aren’t covered by insurance, but you can pay for them with money from a flexible spending account or health savings account, if you have one.

Through Westmed, a chain of urgent care clinics in New York and Connecticut, you can get a virtual phone or video consult between 9 a.m. and 6 p.m. Monday through Friday. Westmed takes insurance and charges $49 for those without coverage.

House calls on demand. The old-fashioned house call is making a comeback, fueled by advances like portable X-ray machines and apps that can make your cell phone function like an ultrasound machine. This option may be especially useful for people who are too ill to get to a doctor, and currently, those who are quarantined at home.

The on-demand house call company Heal, which promises to get a healthcare provider to your home within a few hours from 8 a.m. to 8 p.m. seven days a week, has seen an uptick in calls for its services as the coronavirus outbreak unfolds, according to CEO Nick Desai. While Heal’s doctors can’t test for COVID-19, they can refer symptomatic patients to state and federal health officials. Heal, which operates in more than a dozen cities, accepts many insurance plans, but if yours isn’t covered, the cost is $159.

Remedy, another on-demand house call service, says it will send a healthcare provider to your home within 2 hours. It takes insurance, but if you don’t have coverage, it charges $199 for a house call.

High-tech healthcare hybrids. A growing number of technology companies moving into the healthcare space offer both virtual and in-person care. These hybrids are mainly in major metropolitan areas, and some are still small.

Forward, for example, which launched in 2016, is based in San Francisco and also has several locations in Southern California, New York City, and Washington, D.C. It doesn’t accept insurance, instead charging a $149-per-month fee for 24/7 remote access to its doctors, as well as unlimited in-person doctor visits.

One Medical, a network of primary clinic providers that offers virtual and in-person care, is larger, with 70 clinics in nine cities. It accepts insurance but charges a $199 fee on top of that to use its services. It also has relationships with 6,000 employers who cover the membership fee for workers. Carbon Health, which is based in California, accepts many insurance plans and also offers a virtual visit for a $49 flat fee.

Know the Limitations

Of course, getting care outside a traditional healthcare facility has its limits. “I can ask someone about their breathing, but I can’t look into their lungs,” Mehrotra says. “A telephone or video call can be a good place to start, but where you get care really depends on the condition being addressed.”

Those limitations are especially important to keep in mind right now. “The symptoms of COVID-19 are difficult to differentiate from those of the typical seasonal flu or a common cold,” says Will Kimbrough, M.D., senior medical director of clinical services at One Medical.

At all times, checking with a telehealth provider or calling your doctor can help you decide whether you need to be seen in an office setting or an emergency room, or can safely remain at home, Kimbrough says.

If you suspect an emergency , call 911 right away. That includes difficulty breathing, chest pain, severe pain, broken bones, coughing or vomiting up blood, sharp abdominal pain, unresponsiveness, bleeding that can’t be stopped with direct pressure , and signs of a stroke , such as facial drooping, arm weakness, and speech difficulty.

Additional Coronavirus information and resources:

Read our daily Coronavirus Live Blog for the latest updates and news on coronavirus.

Click here for a page with resources including a COVID-19 overview from the CDC, details on cases in Michigan, a timeline of Governor Gretchen Whitmer's orders since the outbreak, coronavirus' impact on Southeast Michigan, and links to more information from the Michigan Department of Health and Human Services, the CDC and the WHO.

View a global coronavirus tracker with data from Johns Hopkins University.

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