When To Use Telehealth

Telehealth has become a common part of many health plans, offering convenience, flexibility, and lower costs for certain types of care. While virtual visits can be a great option in the right situation, they are not always the best choice.

Knowing when telehealth works well and when in-person care is more appropriate can help employees get the care they need while avoiding unnecessary costs or delays.

When Telehealth Makes Sense

Minor Illnesses and Common Symptoms

Telehealth is often ideal for straightforward concerns, such as:

• Cold or flu symptoms

• Sinus infections

• Allergies

• Sore throats

• Mild skin rashes

• Pink eye

These conditions typically do not require a physical exam or diagnostic testing, making virtual care a convenient option.

Prescription Refills and Medication Questions

Telehealth visits are useful for:

• Routine prescription refills

• Medication side effects

• Adjusting dosages

• Follow-up questions after starting a new medication

These visits are usually quick and may cost less than an in-person appointment.

Mental Health and Behavioral Health Services

Many plans now offer virtual access to:

• Therapy and counseling

• Psychiatric visits

• Stress management support

For many people, virtual mental health care increases access, reduces scheduling barriers, and encourages consistency in treatment.

Follow-Up Visits

If you have already been seen in person, telehealth can work well for follow-up appointments where physical exams are not required. This saves time and often reduces out-of-pocket costs.

When Telehealth Is Not the Best Option

Emergency Situations

Telehealth should never replace emergency care. For symptoms such as chest pain, difficulty breathing, severe bleeding, or signs of a stroke, calling emergency services or visiting the ER is critical.

Conditions Requiring Hands-On Exams or Testing

Some concerns require physical evaluation, imaging, or lab work, including:

• Severe or persistent pain

• Injuries that may involve fractures

• Abdominal pain

• Symptoms that are worsening or unexplained

In these cases, an in-person visit allows providers to properly diagnose and treat the issue.

Complex or Ongoing Medical Conditions

Chronic conditions or complex medical concerns often require in-person visits to ensure accurate monitoring and treatment. While telehealth may be part of ongoing care, it may not replace in-office evaluations entirely.

Understanding the Cost Differences

Telehealth visits often cost less than in-person appointments, but pricing varies by plan. Some telehealth services have flat copays, while others may be subject to coinsurance or deductibles.

Before scheduling, it is helpful to:

• Confirm whether the provider is in-network

• Understand your copay or coinsurance

• Check if the visit applies toward your deductible

Making the Right Choice

Telehealth can be a valuable tool when used appropriately. Choosing the right type of care based on your symptoms helps ensure you receive proper treatment while keeping costs manageable.

If you are unsure whether telehealth or in-person care is the right option, reviewing your plan details or speaking with a benefits advisor can help guide your decision.

Swift Kennedy is always here to help employees understand their benefits and make informed healthcare choices.