What Medicare covers for telehealth right now

Medicare covers telehealth visits with your doctor, nurse practitioner, or physician assistant using video or phone calls. The coverage applies to most of the same services Medicare would pay for in person — office visits, mental health counseling, physical therapy, and many specialist consultations. You pay the same copay or coinsurance you would for an in-person visit, and your deductible counts the same way.

The rules changed during the COVID-19 pandemic and have stayed largely the same since. Medicare now covers telehealth visits with providers who are not in your area, which was not true before. You can also use phone-only visits if video is not possible, though some services still require video. The provider must be enrolled in Medicare and licensed in your state.

Key Takeaways

  • Medicare covers video and phone visits for most services that would be covered in person, including office visits, mental health care, and physical therapy.
  • You pay the same copay or coinsurance as an in-person visit, and your deductible applies the same way.
  • Your provider must be enrolled in Medicare and licensed in your state, but does not have to be in your state.
  • Some services like certain eye exams and hearing tests still require in-person visits, so ask your provider before booking.
  • You need a device with video or phone capability and internet access, but the provider's office handles the technical setup.

Services Medicare covers by telehealth

Office visits with your primary care doctor, cardiologist, rheumatologist, and most other specialists are covered. Mental health visits with a psychiatrist, psychologist, or clinical social worker are covered. Physical therapy, occupational therapy, and speech therapy are covered when ordered by your doctor. Diabetes management visits, kidney disease management, and chronic disease follow-ups are all covered.

Behavioral health counseling for substance use disorder and mental health conditions is covered. Preventive visits like annual wellness exams can be done by telehealth. Medication management visits — where your doctor adjusts prescriptions or monitors how you are doing on current medications — are covered. Home health services that involve a nurse or therapist visiting your home are separate from telehealth and have their own rules.

Some services still require you to be in person. Eye exams for glasses or contacts, certain retinal imaging, and hearing tests usually need to happen at the provider's office. Procedures that require hands-on examination — like checking your reflexes, listening to your heart with a stethoscope, or drawing blood — cannot be done by telehealth. If your doctor thinks you need an in-person visit, they will tell you.

How to set up a telehealth visit

Call your doctor's office and ask if they offer telehealth visits. Many do now, but not all providers use the same system. Ask which platform they use — some use Zoom, some use their own patient portal, some use other video software. The office will send you a link or instructions before your appointment, usually by email or text.

You will need a device with a camera and microphone — a computer, tablet, or smartphone all work. You need internet access, either WiFi or cellular data. Test your device and internet connection a few minutes before the appointment. Find a quiet, private space where you can talk without interruption. Have your insurance card and any medical records or notes about your symptoms ready, just as you would for an in-person visit.

If you do not have internet access or a device, tell your office. Many providers can do phone-only visits instead. If you are not comfortable with video, ask whether a phone visit is an option for what you need. Some services require video, but many do not.

What you pay for telehealth visits

Your cost is the same as an in-person visit. If you have Original Medicare, you pay 20 percent of the approved amount after you meet your deductible. If you have a Medigap plan, it may cover some or all of that 20 percent. If you have a Medicare Advantage plan, you pay whatever copay your plan lists for that type of visit — usually $10 to $50 depending on whether it is your primary care doctor or a specialist.

Your annual deductible counts toward telehealth visits the same way it counts toward in-person visits. If you have not met your deductible yet, you pay the full approved amount until you do. Once you meet it, you pay your coinsurance or copay. There is no extra charge for using telehealth instead of going to the office.

Telehealth during and after the public health emergency

During the COVID-19 public health emergency, Medicare expanded telehealth coverage temporarily. That emergency ended in May 2023, but Congress extended most of the telehealth rules through the end of 2024. Some rules may change after that, so check with your provider or Medicare if you are reading this after 2024.

The rules that are likely to stay include coverage for phone-only visits and coverage for providers outside your state. The rules that might change are the ones about where you can be when you have a telehealth visit — during the emergency, you could be anywhere, but some rules may require you to be in a doctor's office, clinic, or hospital for certain visits. Ask your provider whether any of your regular telehealth visits might be affected.

When telehealth is not the right choice

Telehealth works well for follow-up visits, medication checks, and talking through symptoms. It does not work well if your doctor needs to examine you in person. If you have chest pain, severe shortness of breath, signs of stroke, or other emergencies, go to the emergency room or call 911 — do not use telehealth.

If you have a new symptom that needs a physical exam, ask your doctor whether telehealth is appropriate. Sometimes your doctor will want to see you in person first, then use telehealth for follow-ups. If you are not sure whether a telehealth visit makes sense for your situation, call your doctor's office and ask. They can tell you whether they can help you by video or phone, or whether you need to come in.

How to find Medicare-covered telehealth providers

Start by calling your current doctor's office and asking whether they offer telehealth. If they do, ask how to schedule a visit. If your doctor does not offer telehealth, you can search for providers on Medicare.gov. Go to the "Find Care Providers" section and look for providers who list telehealth as an option.

You can also contact your Medicare Advantage plan directly — they have a list of in-network providers who offer telehealth. If you use a Medigap plan, you can see any Medicare-enrolled provider, so you have more options. Some community health centers and federally may have access to health centers offer telehealth visits and may have sliding-scale fees if cost is a concern, though Medicare will still cover your visit.

Questions to ask your doctor about telehealth

Before your first telehealth visit, ask your doctor's office these questions: What platform or software do you use? Will you send me a link or do I need to read something? Can I use a phone call instead of video? What should I have ready for the visit? Will you need to see me in person for any reason before we do a telehealth visit? How do I get my prescription refilled after the visit?

If you have privacy concerns, ask whether the visit will be recorded and who can see the recording. Ask how your medical records will be stored and whether the platform is find. If you have hearing or vision loss, ask whether the provider can accommodate you — larger text, slower speech, or other adjustments.

Frequently Asked Questions

Does Medicare cover telehealth visits with providers in other states?

Yes. Your provider must be licensed in their own state and enrolled in Medicare, but they do not have to be in your state. This is different from the rules before the pandemic. Some states have additional rules about telehealth, so ask your provider whether they can see patients in your state.

Can I use telehealth for my annual wellness visit?

Yes. Your annual wellness visit — the preventive visit Medicare covers once a year — can be done by telehealth. You still get the same coverage, and you do not pay anything if your doctor is in-network and you have met your deductible.

What if I do not have internet or a computer?

Ask your provider whether they offer phone-only visits. Many do. If your provider does not, you can ask whether they can mail you a tablet or device, though this is less common. Some community health centers have devices available for patients to use during telehealth visits.

Will my telehealth visit count toward my out-of-pocket maximum?

Yes. If you have a Medicare Advantage plan, your telehealth copay or coinsurance counts toward your out-of-pocket maximum just like an in-person visit does. If you have Original Medicare with a Medigap plan, the rules depend on your Medigap plan.

Can I get a prescription from a telehealth visit?

Yes. Your provider can send a prescription to your pharmacy during or after a telehealth visit. Ask your provider how they will send it — some send it electronically, some call it in, and some mail it. Make sure your pharmacy knows to expect it.