Premera offers 2015 Virtual Care coverage benefit to customers

Premera Blue Cross and its affiliate LifeWise Health Plan of Oregon announced Dec. 17 that it will offer virtual care services to its 2 million members as a covered benefit starting Jan. 1, 2015. Customers can access telemedicine services via phone, secure online video, and mobile applications to connect with physicians at any time of day.

Washington State House Bill 1448, passed in 2013, required the reimbursement of medical services received online from a qualified medical provider. However, amendments passed in 2014 allowed heath plans to subject telemedicine to prior authorization and removed the requirement that “telemedicine services be reimbursed on the same basis and at the same rate as in-person services.”

Premera has stated that it is aiming to reduce obstacles in consumers accessing health care services through the telemedicine benefit in 2015 which requires no prior authorization for use and covers service at the same rate as in-person visits.

“By making telehealth services available, our members can have peace of mind that they will have access to virtual care any time of day,” said Rich Maturi, senior vice president of Premera’s Health Care Delivery System. “This service provides a viable alternative when in-person care is a challenge due to geographic distance, limited access to transportation, and a need for care outside of regular doctor office hours.”

Premera customers will have two options in using the virtual care service. They may connect with their primary care physician or pediatrician directly if the office is equipped with telemedicine systems. At this time, roughly 20 percent of network providers have some level of virtual services that they can offer, according to Amy Carter, spokeswoman for Premera.

If a customer’s local physician does not participate in the program, the customer can still receive a medical consultation through Teladoc, a service which connects patients to U.S. board-certified, state-licensed physicians, available 24-hours a day, seven days a week.

Though Premera advises against telemedicine consultations being used to replace primary care doctor visits, the carrier states that the service offers an alternative to expensive “urgent care and unnecessary ER visits.” Type of conditions treated by Teladoc include: bronchitis, respiratory infection, sinus problems, allergies, and influenza, according to the Premera. A Teladoc physician can also diagnose and give select treatments during sessions.