Using insurance with HLTHi (eligibility & copays)

Audience: all

Using insurance for telemedicine services with HLTHi can help reduce your out-of-pocket costs. Many insurance plans may cover telehealth visits, but coverage and copay amounts often vary depending on your provider and plan. Before your telemedicine appointment, it's important to verify your insurance eligibility and understand any copays or fees that may apply. This guide explains how insurance typically works with HLTHi, what to expect regarding costs, and steps you can take to prepare for your visit. Knowing your insurance details ahead of time can help you avoid surprises and make the most of your telemedicine experience.

Red flags — go in person / ER

• If you experience severe chest pain, difficulty breathing, or sudden weakness, seek emergency care immediately rather than relying on telemedicine.
• If you notice sudden confusion, loss of consciousness, or severe allergic reactions (such as swelling of the face or throat), call emergency services right away.
• If you have uncontrolled bleeding or serious injuries, do not wait for a telemedicine visit; go to the nearest emergency facility.

What telemedicine can do

• Routine follow-ups and chronic condition management
• Minor acute illnesses like colds, flu, or mild infections
• Medication reviews and prescription refills
• Mental health counseling and support
• Health education and preventive care advice

What telemedicine cannot do

• Emergency medical conditions requiring immediate physical intervention
• Procedures needing physical examination or diagnostic tests not available remotely
• Severe injuries or symptoms indicating life-threatening situations
• Complex diagnostic evaluations requiring in-person assessment
• Administration of controlled substances subject to strict regulations

Understanding Insurance Coverage for Telemedicine

Many insurance plans now include telemedicine services as part of their coverage. Coverage can vary widely, so it's important to check with your insurance provider to see if telehealth visits with HLTHi are covered. Some plans may require a copay or coinsurance, similar to in-person visits. Understanding these details helps you plan for any costs you might incur.

Checking Eligibility and Benefits

Before your telemedicine appointment, verify your insurance eligibility and benefits. You can do this by contacting your insurance company directly or using their online member portal. Confirm that your plan covers telemedicine, what services are included, and what your financial responsibility might be. HLTHi may also assist with verifying your coverage during the appointment scheduling process.

Copays and Out-of-Pocket Costs

Copays for telemedicine visits often mirror those for in-person visits but can vary by insurance plan. Some insurers may waive copays for telehealth during certain periods or for specific services. Be prepared to pay any applicable copays at the time of your visit or as directed by HLTHi. Understanding your plan’s cost-sharing requirements helps you avoid unexpected bills.

Preparing for Your Telemedicine Visit

Gather your insurance information, including your member ID and group number, before your appointment. Have your payment method ready in case copays or fees apply. Ensure your contact and billing information are up to date with HLTHi. Being prepared helps your visit go smoothly and reduces delays related to insurance processing.

What to Do if You Have Insurance Questions

If you have questions about your coverage or costs, contact your insurance provider directly. HLTHi staff can help explain how telemedicine visits work but cannot provide detailed insurance plan information. Understanding your benefits fully is key to managing your telehealth care costs effectively.

How to prepare for your tele-visit

• Confirm your insurance coverage for telemedicine services with your provider.
• Have your insurance card or member information available during appointment scheduling.
• Prepare a valid payment method for any copays or fees.
• Ensure your contact and billing information with HLTHi is current.
• Test your internet connection and device to support a smooth telemedicine visit.

After your tele-visit

• Review any instructions or prescriptions provided during your telemedicine visit.
• Follow up with your primary care provider if recommended.
• Monitor your symptoms and seek in-person care if your condition worsens.
• Keep records of your telemedicine visit and any related billing statements.
• Contact HLTHi support if you have questions about your visit or charges.

FAQs

Will my insurance always cover telemedicine visits with HLTHi?

Coverage for telemedicine varies by insurance plan. Many insurers include telehealth services, but it's important to check your specific plan to understand what is covered and any costs you may be responsible for.

How do I find out what my copay will be for a telemedicine visit?

Your copay amount depends on your insurance plan. You can find this information by reviewing your plan details online or contacting your insurance provider directly. HLTHi may also provide estimates based on your plan.

What if I don’t have insurance?

If you do not have insurance, you may still use HLTHi’s telemedicine services but will be responsible for the full cost of the visit. Contact HLTHi for information about pricing and payment options.

Can I use insurance from any country with HLTHi?

Insurance acceptance depends on the insurer and the region. HLTHi recommends verifying with your insurance provider whether telemedicine services with HLTHi are covered, especially if your insurance is from outside your country of residence.

Will I receive a bill if my insurance does not cover the telemedicine visit?

Yes, if your insurance does not cover the service or if you have not met your deductible, you may receive a bill for the portion not covered. HLTHi will provide billing information after your visit.

Sources

1. Telehealth: What You Need To Know — MedlinePlus, U.S. National Library of Medicine.
2. Telehealth Guidance — Centers for Disease Control and Prevention (CDC).
3. What Is Telemedicine? — Mayo Clinic.
4. Understanding Health Insurance — Agency for Healthcare Research & Quality (AHRQ).

This telemedicine guidance is for educational purposes only and is not a substitute for professional, in-person medical care. If you have a medical emergency or serious symptoms, seek immediate care from a healthcare facility.