Medicare telehealth coverage is changing, not stopping entirely

Medicare is not ending telehealth in 2025, but the rules around which visits your plan will cover are shifting. The main change: the temporary telehealth flexibilities that started during the COVID-19 pandemic are expiring on December 31, 2024. Starting January 1, 2025, Medicare will return to stricter rules about which types of visits can happen by video or phone, and where your doctor has to be when they see you.

The biggest impact will be on routine office visits and mental health appointments. Many people have been able to see their regular doctor by video from home. Under the new rules, some of those visits will need to happen in person or will only be covered if your doctor is in a rural area or a specific type of facility. Mental health visits have more flexibility, but even those have limits on how many can happen by telehealth in a year.

If you use telehealth now, you should contact your doctor's office and your Medicare plan before the end of 2024 to understand what will still be covered for you starting in January.

Key Takeaways

  • Medicare's temporary telehealth rules expire December 31, 2024, and stricter coverage rules take effect January 1, 2025.
  • Routine office visits by video will be covered only if your doctor is in a rural area or certain types of facilities, or if your plan offers them as an extra benefit.
  • Mental health visits by telehealth will still be covered, but Medicare limits how many you can have per year without an in-person visit.
  • Your Medicare Advantage plan may cover more telehealth than Original Medicare does, so check your plan documents or call your plan directly.
  • Contact your doctor's office now to find out which of your regular visits will move back to in-person starting in 2025.

Which telehealth visits will still be covered after December 31, 2024

Medicare will continue to cover some telehealth visits under the permanent rules. Mental health visits — therapy, psychiatric appointments, and counseling — remain covered by video or phone, though there are limits. You can have up to two mental health visits per calendar year by telehealth without an in-person visit first. After that, you need to see the provider in person before more telehealth visits are covered.

Certain types of doctors in rural areas can still see patients by video. If your primary care doctor or specialist is in a county that Medicare designates as rural or underserved, telehealth visits with that doctor remain covered. Visits with providers at federally may have access to health centers, rural health clinics, and some hospital outpatient departments also stay covered by telehealth.

Some specific services — like certain mental health crisis visits, home health evaluations, and dialysis-related visits — have their own telehealth rules that do not change. If you have a chronic condition that requires regular monitoring, ask your doctor whether your specific type of visit qualifies under the permanent rules.

What changes for routine doctor visits and office appointments

The biggest change is that routine office visits with your regular doctor will no longer be automatically covered by video. If your doctor is in an urban or suburban area and is not part of a rural health clinic or hospital outpatient program, Medicare will not cover a video visit for a standard checkup or follow-up appointment starting January 1, 2025.

Your doctor can still offer a video visit, but you would pay out of pocket unless your Medicare Advantage plan includes telehealth as an extra benefit. Some Medicare Advantage plans do cover routine telehealth visits as part of their plan design, so the coverage depends on which plan you have.

If you need an urgent care visit — something that cannot wait for an in-person appointment — some telehealth urgent care services may still be covered, but this varies by plan and provider. Check with your plan before using an urgent care telehealth service to avoid a surprise bill.

How Medicare Advantage plans handle telehealth differently

Medicare Advantage plans (Part C) have more freedom than Original Medicare to decide what telehealth services they cover. Many Medicare Advantage plans already cover routine office visits by video as an extra benefit, and many plan to keep this coverage in 2025 even though Original Medicare will not.

If you are in a Medicare Advantage plan, your plan's telehealth coverage may be broader than what Original Medicare offers. Some plans cover unlimited telehealth visits with in-network doctors, while others limit it to a certain number per year. A few plans cover telehealth visits with out-of-network providers, though this is less common.

You need to check your specific plan's coverage details. Call the customer service number on your Medicare Advantage card or log into your plan's website to see what telehealth services are covered in 2025. Do not assume your coverage stays the same — plans can change their telehealth benefits year to year.

Steps to take before the December 31 important date

Contact your primary care doctor's office and ask which of your regular visits will need to move to in-person appointments starting January 1, 2025. If you see a specialist regularly by video, ask the same question. Get a clear answer about whether your doctor's office is in a rural area or part of a facility that qualifies for continued telehealth coverage.

Call your Medicare plan — either your Medicare Advantage plan or your supplemental insurance plan if you have Original Medicare — and ask what telehealth services are covered in 2025. Ask specifically about mental health visits, routine office visits, and any chronic condition visits you have regularly. Request a written summary or ask them to note your account with the details.

If you use a telehealth app or service separate from your doctor's office, contact that service and ask whether your visits will still be covered by Medicare in 2025. Some telehealth companies have already announced changes to their Medicare coverage, and you should know this before your next visit.

If you take medications that your doctor currently prescribes by telehealth, ask whether you will need an in-person visit to renew prescriptions starting in January. Some doctors can still prescribe by phone or video under certain rules, but it is better to know now than to run out of medication.

What to do if your regular telehealth visits will no longer be covered

If your doctor tells you that your routine visits will no longer be covered by Medicare telehealth, you have several options. You can schedule in-person visits instead. If travel or mobility is difficult, ask your doctor whether they can see you less frequently in person and handle routine check-ins by phone or email outside of a billable visit.

If you are in a Medicare Advantage plan and your plan does not cover the telehealth visits you need, you can switch plans during the annual enrollment period (October 15 to December 7 each year). If the change happens mid-year and affects your care significantly, you may be able to make a change outside the enrollment period — contact your plan to ask about this.

Some community health centers and federally may have access to health centers offer telehealth visits that are covered under the permanent Medicare rules. If your current doctor cannot offer covered telehealth, ask whether your local health center can. These centers often serve people with Medicare and may have more flexible telehealth options.

Mental health and behavioral health telehealth coverage in 2025

Mental health visits remain one of the strongest areas for telehealth coverage under the new rules. Psychiatry, therapy, counseling, and behavioral health visits are covered by video or phone, with the main limit being that you can have up to two such visits per calendar year without an in-person visit first.

After two telehealth mental health visits in a calendar year, you must have at least one in-person visit with that provider before more telehealth visits are covered. This means if you see a therapist weekly, you will need to come in person at least once every few months. The in-person visit can be brief and does not have to be a full session.

If you are in crisis or having a mental health emergency, telehealth crisis services may be covered outside these limits. Ask your mental health provider about their emergency telehealth options. Some providers also offer telehealth visits for medication management separately from therapy visits, which may have different coverage rules.

Frequently Asked Questions

Will my mental health therapy visits still be covered by video in 2025?

Yes, but with a limit. You can have up to two mental health visits per calendar year by telehealth without an in-person visit. After that, you need one in-person visit before more telehealth mental health visits are covered. This applies to therapy, psychiatry, and counseling.

Can my doctor still prescribe medications by telehealth after December 31, 2024?

It depends on the type of visit and your doctor's location. If your doctor is in a rural area or part of a may have access to facility, yes. For other doctors, Medicare covers the telehealth visit itself only under certain conditions. Ask your doctor's office whether they can continue prescribing by phone or video outside of a billable visit.

What if my Medicare Advantage plan covers telehealth visits that Original Medicare does not?

That is allowed. Medicare Advantage plans can offer broader telehealth coverage than Original Medicare. Check your plan documents or call your plan to confirm what is covered in 2025. If your plan is dropping telehealth coverage you rely on, you can switch plans during open enrollment.

Do I have to pay out of pocket if my doctor offers a telehealth visit that Medicare will not cover?

Yes, unless your Medicare Advantage plan covers it. If your doctor offers a telehealth visit that is not covered by your Medicare plan, you would be responsible for the full cost unless you have agreed to this in advance. Ask your doctor's office about costs before scheduling.

Can I see a specialist by telehealth in 2025 if they are in a rural area?

Yes. Specialists in rural areas can continue to see Medicare patients by telehealth. If your specialist is in a county that Medicare designates as rural or underserved, telehealth visits remain covered. Ask your specialist's office whether they are in a may have access to rural area.