Comprehensive Guide to Telehealth in 2023

Americans are adopting telehealth services in growing numbers and for numerous reasons. Some reasons are obvious -- foremost, the COVID-19 pandemic that prompted many of us to greatly reduce our activities outside of the home.

When asked in 2019, only about 10% of Americans had used telehealth services, but a more recent survey has that number at over 40%. 76% of hospitals in the United States are now offering telehealth medical visits via voice calls, video visits, or secure messaging. Investors spent over $9 billion on telehealth companies in the first half of 2020 alone, and the amount of global investment grew 169% in 2021 compared to the prior year.

The pandemic, in many ways, accelerated a movement that was well underway. It has brought changes in outlook on both sides of the healthcare picture -- patient and provider. This attitudinal shift and recent (and temporary) deregulatory moves at the federal level have caused massive increases in the number of people turning to telemedicine -- working virtually with doctors -- one of the more dramatic expressions of how telehealth can transform our healthcare system.

Because telehealth encompasses such a wide array of services, you might have been a telehealth user in the past without even thinking of it. This guide will introduce you to the various facets of telehealth today; how they can improve healthcare access and outcomes for patients; the potential for telehealth to help stabilize cost and burden for the healthcare industry broadly; and also some of the foreseeable challenges that need to be addressed so that they don't impair the effectiveness of telehealth as services continue to expand.

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The term telehealth, in reality, encompasses a vast set of technologically driven services that allow us to address health needs remotely -- including:

• Telemedicine services, which let you see a doctor in a virtual visit
• Health monitoring devices that share vital details with your health team and various assigned caretakers
• Secure portals for messaging via text or email with a healthcare team
• Apps that track personal activities that affect your health, such as footsteps or calories
• Online therapy services that bring mental health care to the comfort of your home
• Testing kits that allow you to check discreetly and privately for a multitude of health conditions, from STDs to heavy metal poisoning
• Telepharmacy services and networks that partner with telehealth providers to deliver your prescriptions directly and discreetly to your door
• Specialized services that address men's and women's ongoing health concerns with unbeatable discretion and autorenewing options, so you don't have to keep making appointments

The facets of telehealth are numerous and they steadily proliferate. This guide will focus more on the tangible benefits that telehealth brings to patients. As Americans adopt telehealth services in growing numbers, they report fairly high satisfaction with it. Telehealth can indeed bring many advantages for the patient.

Telemedicine comprises one large facet of telehealth -- and a facet that patients and healthcare professionals historically regarded with some skepticism because, for a time, the ambitions of telehealth weren't matched by the technological capabilities to make it convenient and effective. Not only that, but various regulations sometimes interfered with the ability to provide adequate care for people remotely.

Times have changed, however, with telemedicine visits skyrocketing and people reporting generally high satisfaction -- higher than you would expect to see for a brand-new change in healthcare routines.

The growing ranks of telemedicine companies now let you see doctors and other healthcare professionals via virtual visits. This can usually (though not always) be done using whatever device you prefer -- tablet, smartphone, or computer. You typically have a choice of a voice call, video visit, or emailing/messaging, though some states require a video visit.

Companies do differ in their services -- not just in technical details like whether you can video chat from your laptop, but in several other key ways, such as:

• Price and pay structure
• Insurance coverage
• Usability and transparency
• Scope and nature of care
• Use of appointments for scheduling purposes

Telemedicine services aren't all the same; there's a great deal of variety, just as there are various reasons why patients access telemedicine:

• For immediate, urgent care (non-emergency situations)
• To establish a primary care relationship with a dedicated doctor
• To access specialty care such as psychiatry or women's reproductive care
• To get a specific, routine prescription you need but without the hassle of periodic trips to the doc's office or pharmacy

There are also limitations to what telemedicine can provide. Doctors must be cautious when prescribing medication without an in-person exam. Consequently, certain medications aren't accessible through telemedicine.

How does telemedicine work

Telemedicine delivers the attention of a healthcare professional to you wherever you are, at the touch of your fingertips. Though there are variations, seeing online doctors via telemedicine follows a basic pattern:

1. Create an account. As you set up your account, you'll be prompted to enter information about your health as well as your billing into their secure interface.
2. Select the service you need. Once you've entered your information, you will indicate the telemedicine service you feel that you need.
3. Visit the doctor. Some companies require an appointment, while others make it optional or don't accept appointments at all. Companies also vary with regard to the general duration of these visits.

The best telemedicine companies help you prevent gaps in your health records by connecting with your primary care provider.

Our guide to telemedicine can tell you more about this exciting and rapidly developing space.

What are the costs?

Patients can expect prices to vary fairly widely for telemedicine services -- ranging from $20 per service to $100/month, depending on a few main factors, including:

• Whether insurance is accepted
• Pay structure (per service or membership)
• The nature of service -- a dedicated, robust primary care relationship would cost more than a one-time, immediate care service

At the high end of prices are companies like SteadyMD, which can almost entirely replace your current PCP relationship with a virtual concierge healthcare experience. You get a dedicated doctor who tailors your telemedicine service specifically to you and your needs and makes time for you whenever you need care. You can ask unlimited questions and enjoy a level of attention so high that it will probably shock you. But if you aren't prepared for it, the price will shock you too.

At the other end of the price spectrum are a la carte and one-time service companies like HeyDoctor, which provide almost a fast-food type of menu of health services at low cost. Prices are so low that they beat many common insurance copays for the equivalent services in a traditional setting -- which is good since insurance likely isn't accepted.

And somewhere in the middle of these extremes are companies like Doctor on Demand, Plushcare, and Lemonaid (check out our full Lemonaid review), which structurally find ways to keep costs low while providing high-quality care. These services likely will be the best telemedicine option right now for the widest group of people.

Few areas of healthcare, if any, are better suited for telehealth approaches than mental health care. For many people, online counseling sessions with a trusted therapist prove just as helpful as in-person sessions. Companies have developed intuitive app and website experiences that make access easy, and you can’t beat the convenience or privacy of therapy from the comfort of home or wherever you happen to be.

If you already see a trusted therapist, it's possible that she or he offers telehealth services already. If you're looking for a good online therapist, however, there are several very reputable and easily recommendable companies from which to choose. Some companies -- like BetterHelp and Talkspace -- can connect you with therapists across a wide range of subject specialties. Other online therapy companies focus exclusively on specific areas like teen counseling, couples counseling, LGBTQIA+ counseling, and more. The best choice for you depends on your goals and preferences for the therapy, as well as your budget.

To learn more about your options, we have a guide that helps you choose the best online therapy to suit your goals. You can also learn more about two recommended online therapy providers by reading our BetterHelp review and our Talkspace review.

How online therapy works

Specifics differ somewhat from service to service, but the process of getting started with online therapy is quite straightforward. The general pattern is as follows.

1. Answer a brief questionnaire. This provides the company with some information about your health, your therapy goals, and the needs you perceive. You also will be able to provide input about characteristics you look for in a counselor, but if this is your first time seeking therapy, don't worry -- you'll have the opportunity to switch counselors anytime during the service if desired.
2. Create an account. You can usually be quite anonymous, using an alias if you'd prefer not to use your real name.
3. Get matched to a counselor. Telehealth companies vary in how they internally match you to a counselor, based on the information you provided.
4. Select the plan you'd like, and begin. Plans vary in price and amount of therapy per week or month. BetterHelp lets you try a week for free also, which is a very useful feature for those of us trying our therapy via telehealth for the first time.

What to expect from online therapy or psychiatric care

Once you have signed up for a plan, online therapy makes it very easy for you to interact meaningfully with your counselor or psychiatrist via website or app interface. Top companies allow you to:

• Interact with your counselor via text messaging as often as you need, with predefined response windows from your counselor (always pretty quick turnaround).
• Set up live therapy sessions via chat or video.
• Change to a different counselor or therapy plan if it's not working out perfectly for you.
• Get a necessary medication prescribed for anxiety or depression for instance (only possible through psychiatric telehealth)

Telehealth also delivers one of the great conveniences and diagnostic tools of modern life directly to your doorstep: the at-home health test. Testing grows increasingly sophisticated and affordable, with rapid turnaround and unrivaled convenience and privacy. And you can test for numerous health conditions and concerns.

Disease screening (including STDs)

With infection rates from common STDs dramatically on the rise in American in recent years, the CDC emphasizes routine testing as a vital tool in identifying infections so that we can prevent further spread.

Thankfully telehealth solutions make testing easier than it's ever been in the past. Not only is testing more convenient than it used to be, but at-home STD testing means that you can identify infections with more privacy than ever before. Top testing companies rely on the most sophisticated testing methods and equipment; use only certified labs; and deliver highly accurate results within days. Test kits arrive discreetly at your front door, impossible for anyone but you to identify as an STD test.

To learn all about your options and what to expect, visit our comprehensive guide to choosing the best at home STD test.

In addition to STD testing, telehealth companies offer valuable at-home tests to identify other conditions like diabetes, high cholesterol, Lyme disease, and risk of certain cancers and thyroid diseases. Testing from home is a convenient first step that helps you determine if you need a telemedicine consultation or in-person visit. Some telehealth companies even provide telemedicine consultation with a doctor -- free of charge -- if you test positive for certain diseases like STDs.

Genetic testing

By analyzing your DNA and looking at what genetic markers are present, DNA testing companies can tell you about your genetic risk of developing certain health conditions. For example, 23andMe tests for 13 different disease risks, including:

• Breast cancer
• Late-onset Alzheimer’s disease
• Celiac disease
• Age-related macular degeneration
• Parkinson’s disease

It is important to keep in mind that these tests are not going to determine whether you have a given disease or condition, or whether you will develop them. Rather, the tests report whether you have genetic factors that may influence your chances of developing certain conditions.

At-home genetic testing can also indicate whether you're a carrier for over 40 different genetic variants that could cause your child to inherit them and develop conditions like cystic fibrosis or sickle cell anemia, to name a couple of examples.

Genetic tests can also be used to tell you about dietary intolerances and aspects of your health related to fitness and muscle strength, but while these tests are highly popular, you must take them with a grain of salt.

To learn more about what this type of testing can do for you, check out our comprehensive guide to the best health DNA tests.

Hormone testing

At-home tests for both men and women can measure important hormones to help assess potential imbalances, which could lead you to feel poorly or could impact fertility.

There are many hormones associated with the health and well-being of women. Among the most important are:

• FSH (Follicle Stimulating Hormone)
• Anti-Müllerian hormone (AMH)
• Prolactin
• Estradiol
• LH (Luteinizing Hormone)
• Progesterone

Testing for these hormones can give women a lot of very important information, including details about their ovarian reserve. You can learn more about these hormones and others -- and how testing might help you -- by visiting our Modern Fertility review.

Meanwhile, for men, testosterone is the main sex hormone and is responsible not only for proper reproductive function and sex drive, but also for healthy energy levels, muscle mass, and bone density.

Food sensitivity and nutrition

Your telehealth testing options include tests to identify nutritional deficiencies as well as food intolerances and allergies. In terms of nutritional deficiencies, tests can check for abnormal levels of important vitamins such as B-vitamins and vitamin D. Unusual levels can lead to health concerns or indicate existing undiagnosed conditions.

Food sensitivities are, for the most part, non-life-threatening intolerances that can make you feel very unwell, while food allergies are much more severe and possibly life-threatening reactions to certain foods. One in ten Americans lives with a food allergy.

While the "elimination diet" method may be the gold standard for diagnosing food sensitivities, this can take a long time to complete. Therefore, if you are anxious to pinpoint your problem foods quickly and think it’s worth the money, a food sensitivity test can be a way to jump-start the process. To learn more, visit our guide to finding the best food sensitivity test.

Heavy metals testing

At-home heavy metal test kits are useful for ruling out poisoning from the several most likely heavy metal toxins in our lives -- mercury, lead, arsenic, and cadmium. Through our living or work environment or through our diets and drinking water, we can be exposed to harmful levels of these metals. Because symptoms resemble many other conditions, testing is a vitally important step in identifying the underlying problem. Telehealth has made this type of testing convenient and affordable at an important time.

You can learn more by visiting our guide to finding the best heavy metal testing kit for you.

Prominent health testing companies

Innerbody Research has purchased and tested hundreds of kits from numerous at-home health testing companies in order to provide honest reviews and guides that help you in your quest for good telehealth services. We encourage you to learn more about top companies and what tests they offer by visiting our reviews:

• Everlywell
• myLAB Box
• LetsGetChecked
• STDcheck

Telehealth with a focus on men's health concerns has become one of the fastest-growing and most competitive areas of telehealth services. You might have seen ads for Hims, Keeps, and Roman online and on TV. It's no surprise why men's telehealth is surging:

• Men want discreet care for concerns that some of them find embarrassing (unfortunately).
• Conditions like male pattern hair loss and erectile dysfunction are very common.
• Telehealth companies allow you to see a doctor and get a prescription from home, and receive medication on autopilot, delivered to your home, for great convenience.

Men's telehealth programs continue to expand in new directions. Top companies like Hims are broadening their services to include primary care and mental health as investment and users balloon.

Services vary depending on the company. Most expansively, as with Hims for instance, you can find the following core services:

In our testing, we have been most impressed by Hims, which covers all of the aforementioned bases in user-friendly and affordable ways -- read our full Hims review for more details. And check out our Keeps and Roman reviews to learn more about the competition.

The process with these telehealth companies is very streamlined and straightforward.

1. After identifying the telehealth service you want to order, you will be asked to fill in a health questionnaire if the service may involve a prescription treatment.
2. A doctor reviews your situation -- and possibly consults directly with you to address any lingering questions or concerns -- and then determines if you're a good candidate for the treatment.
3. If it's a suitable treatment for you, then the company prescribes it, their pharmacy network fulfills it, and you receive the treatment swiftly in the mail.

When you compare that to the traditional route of getting a prescription, it becomes clear why many men are turning to telehealth.

Maybe the only arena more hotly contested than the men's telehealth services niche is that of women's telehealth. Popularity here is increasing for the same reasons as with men’s telehealth, but with the added factor that access to healthcare for women traditionally is a complex and often troublesome picture nationwide. While service options continue to expand, thankfully telehealth is bringing some much-needed convenience and discretion to the picture.

As with the men's telehealth companies, companies like Hers allow women to access non-prescription and prescription treatments with relative ease.

For prescription treatments, the process for women is the same as for men.

1. The company will connect you with a doctor for a quick consultation after providing some health information and medical history.
2. You tell the company what you're looking for, and the medical professional with the telehealth company determines whether the treatment path is suitable for you.
3. If so, you're set -- the company prescribes and ships the treatment directly to you and will even set your order to autorenew if you like that added layer of "set and forget".

Some top women's telehealth companies like Hers offer an impressive and growing set of services, though some companies focus strictly and more fully on one or another particular type of service.

Hers is the star of the show right now and our favorite company for women's telehealth based on testing. Learn more with our full Hers review, and stay tuned as Hers develops its new primary care and mental health services. This space in general continues to expand with a growing cast of characters including not only Hers but also Uqora, Nurx, Rory, Cora, and Favor (formerly Pill Club).

There are numerous smartphone apps offering their own brand of telehealth service to you, making you a telehealth user without even realizing it. Among other things, these apps can:

• Track your footsteps each day
• Record your caloric intake, to help with weight management
• Monitor your pulse, respiration rate, and body temperature
• Keep your personal health records accessible (and available in case of a health emergency)
• Notify you when it's time to take medications

Beyond this casual, but very useful (and potentially life-saving) type of telehealth we may buy from an app store, we also use medical devices to serve telehealth purposes.

• Medical alert services like Philips Lifeline detect if a person has fallen, and send proper notifications to a care team.
• Sophisticated pill dispensers help patients with complex medication schedules avoid missed doses. These devices can also notify caretakers when a dose is skipped.
• Devices that we wear can measure and transmit information about everything from blood pressure and blood sugar levels to how soundly we sleep or whether our gait has changed in a potentially significant way.

Even with all of the benefits of telehealth and the general satisfaction of people trying telehealth services for the first time, this is an industry still in its early stages. First, there are known and intrinsic limits to the kind of medical care you can receive virtually:

• Certain prescription medications, which serve valuable purposes for patients in some situations, are nonetheless too risky to prescribe remotely at this time, due to the potential for abuse.
• No matter how good telehealth services may be, you just can't replace some in-person healthcare like imaging and routine physical exams.
• Beyond controlled substances, telehealth providers have room to improve in terms of the selection of available prescription medications for certain conditions. In some cases, while treatment options are available, they're much more limited in telehealth than traditional settings.
• Telehealth will only appeal to people who don't mind important interactions over devices. People who don't spend much time online and are easily overwhelmed by apps and websites will likely have a difficult or frustrating time accessing telehealth.

Beyond that, there are also several clear areas of friction where improvement and refinement are needed as telehealth companies continue to grow and develop.

It's still uncertain exactly what the post-Covid-19 world will look like or when Covid-19 as a threat to wellbeing will be firmly in our collective rearview mirror. Some health experts predict that "post-Covid" could be more than a year away. At some future time, though, the risks from this particular virus will be more manageable for us as a society and we will resume versions of what we recognize as "normal", or closer to it.

But "normal" will likely look different than it did before the emergence of this pandemic. Some structural changes in how we all conduct business and go about our everyday lives will most likely never fully reverse. It's likely that more people will work remotely than ever before. Some social adjustments may become permanent. How we dine in restaurants or fly in airplanes might look a lot different as well.

And healthcare, having accelerated faster into the virtual space than anyone thought -- due to necessity, previous trending, and rapid deregulation -- will likely continue on a growing telehealth trajectory. Why? In the end, it probably boils down to dollars and cents (which, in their physical form, may also go extinct much faster than anyone thought).

Telehealth has the potential to be a rare win-win in healthcare:

• Patients, free from having to go to a doctor's office for every health need, from routine prescriptions to quick questions, save time and money on a growing list of services.
• Overburdened healthcare systems can save money by providing services remotely while preserving clinics and hospitals more for patients who require in-person care.

We all have gotten a big first taste of telehealth -- or most of us have, at any rate. Those who haven't yet soon will. While there are known obstacles to that growth -- the complex picture of health insurance, the need for temporary deregulation to morph into a more permanent and predictable picture, and more thorough insurance coverage -- nonetheless everyone perceives clear benefits of telehealth continuing to grow.

If you use a medical alert device, engage with your traditional doctor via a message portal, or use apps that allow you to track your caloric intake, then you are already a telehealth consumer to some extent. But for the other services that have been the main focus of this guide, here are some tips for getting your feet wet:

Look for free trials

If you're new to telemedicine and not sure how compatible it will be in your life, you might want to try Plushcare first because they offer a free 30-day trial period. Similarly, BetterHelp lets you try online therapy during a 7-day free trial. Even a week of this service can help you decide if it's right for you.

Check insurance coverage before making big investments

The insurance picture, as described above, isn't fully fleshed out for telehealth yet. Major insurance providers are the likeliest to be accepted, but in many cases insurance isn't accepted at all at this time. However, you'll find that many telehealth services are prices so low that they are comparable to normal health services with insurance coverage.

Start off modestly

You don't have to dive fully into the water right away, so to speak. You could think of telemedicine as kind of a more advanced level of telehealth than ordering a routine STD test or food sensitivity test.

So if you feel bewildered, start off with something that is more like ordering a product on Amazon than it is like accessing traditional healthcare in a radically new setting. Once you are comfortable with the process of looking at test results in a secure interface (via website or app), then you could consider trying a virtual doctor's visit to get a routine prescription. If that goes well, try a primary care visit. By that point, you'll be nearly as much of a veteran of telehealth as anybody (remember, this is new for everyone).