What Can I Use One Medical Virtual Visits For?

One Medical is a membership-based primary care service that provides subscriptions with concierge medical care for $199.99 per year. One Medical currently has about 125 primary care office spaces nationwide and an option for virtual visits. Virtual visits are performed through the One Medical virtual care platform. The virtual care platform allows members to discuss chronic conditions, long-term health, and preventive care with their providers.

One Medical Virtual Visit   

With the $199.99 annual plan, all One Medical members can access on-demand virtual care via the Virtual Care app-based platform. It's important to note that One Medical treats virtual care like traditional in-office primary care visits. Therefore One Medical will bill your insurance like a conventional office visit.  

One Medical has two offerings for virtual visits; video chat and remote visits. Video chat provides on-demand and urgent care to users 24/7, while Remote visits are best suited for non-urgent matters that a doctor would handle during regular operating hours. Another key difference between both virtual visit offerings is that the cost of video chats is included in your annual membership fee. In contrast, remote visits are billed to your insurance plan. Although you can use remote visits for various reasons, each health concern might be billed to your insurance differently. Your copay will vary depending on the care you receive. The chart below has additional features for each type of care. 

Video Chat vs. Remote Vist 

One Medical has a definitive list of which conditions or health issues you should utilize virtual care for. Instead, they recommend utilizing virtual visits for everyday health concerns or if you need guidance on the next steps for seeking out care – such as going to the ER. A few examples of conditions that can be evaluated via virtual visit: 

• Colds and Flus
• Seasonal Allergies
• UTIS
• Yeast Infections
• Skin Conditions
• Headaches and Migraines
• Coughs
• Minor injuries like bruises

About One Medical   

One Medical’s subscription plan provides members with concierge primary care services in person at one of their 125 clinical sites or via virtual and remote care. It is important to note that OneMedical operates as supplement coverage to your existing insurance plan and is not a substitute for a traditional health plan. 

One Medical offers specialized plans based on age groups: Adults under 65, Adults 65+, and Kids. Both adult plans are $199.99 per year, and the Kids plan is $144.00 per year. According to the OneMedical services page, members can access services from seven main categories of care:

Care Categories at One Medical

One Medical Cost  

Although One Medical is a membership-based plan, it's important to note that the annual fee does not cover the cost of care. As a supplement to traditional insurance plans, One Medical directly bills your insurance plan. Your insurance benefits dictate the amount you pay out-of-pocket. The steps below outline One Medical's billing process: 

One Medical Bills Your Insurance Plan  

Similar to how your traditional healthcare provider submits billing codes for the services you received during your visit. One Medical will bill your insurance based on the care and services you received during your virtual visit. 

Insurance Plan Pays a Portion of the Bill  

This is similar to traditional insurance, in which certain services are 100% covered by insurance while others are partially covered, leaving you with a copay to pay out-of-pocket.

One Medical Provides an Explanation of Benefits (EOB)  

Your Explanation of Benefits (EOB) outlines what your insurance covered, what services were not covered, and the amount that may appear on your final bill. 

One Medical Notifies You of Your Final Bill  

One Medical will notify you via email when your final bill is ready to be viewed and paid. This can take up to a month to process. Once you receive the final bill, the payment will be made through their billing platform.  

Bottom Line  

Membership-based healthcare options are revolutionizing how individuals receive primary care. With One Medical, you can access virtual care and medical guidance at your fingertips. However, as a supplementary insurance option, the amount you will likely pay out-of-pocket for each visit can significantly vary. With the added membership fee, your annual cost can be much higher than expected.