Online doctor visits, also known as telehealth or telemedicine, have become a widely accepted way to receive healthcare, and Medicare does cover these services. This remote access includes various forms, such as two-way video communication, virtual check-ins, and secure messaging through patient portals, all of which are covered under specific Medicare rules. Coverage specifics depend on whether a beneficiary is enrolled in Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C).
Original Medicare Coverage for Telehealth Services
Original Medicare, specifically Part B, covers a wide range of medically necessary telehealth services, treating them similarly to in-person outpatient visits. This coverage includes routine office visits, consultations with specialists, and various preventive health screenings. The services must be provided by an eligible healthcare professional who is not in the patient’s physical location at the time of the virtual visit. Geographic and originating site restrictions have been temporarily eliminated, allowing patients to receive services in their own homes regardless of location. This flexibility is currently guaranteed through January 30, 2026, for many services.
The covered services typically require an interactive telecommunications system, meaning two-way, real-time audio and video capabilities for the remote connection. Common telehealth services covered include the management of recurring conditions, post-surgical follow-up care, and prescription management. Medicare also covers virtual check-ins and e-visits, which are distinct from full telehealth visits. Virtual check-ins are brief communications, typically five to ten minutes, with a provider via phone or video to decide if an office visit is needed. E-visits involve secure online communication through a patient portal over a period of up to seven days.
Understanding Patient Costs and Co-Pays
When a telehealth service is covered under Original Medicare Part B, the beneficiary’s financial responsibility is the same as it would be for an in-person office visit. The patient is first required to meet the annual Part B deductible, which is $257 in 2025. Once the deductible has been satisfied, the beneficiary is generally responsible for 20% coinsurance of the Medicare-approved amount for the service. For example, if the Medicare-approved cost for a virtual visit is $100, the patient would pay $20 after the deductible is met.
Beneficiaries with supplemental coverage, such as a Medigap policy, may have their out-of-pocket costs, including the 20% coinsurance and the deductible, covered by that secondary insurance. Providers must accept Medicare assignment for the patient to only be responsible for the standard coinsurance and deductible.
Telehealth Coverage Through Medicare Advantage Plans
Medicare Advantage (MA) Plans, or Part C, are offered by private insurance companies approved by Medicare and must provide at least the same level of coverage as Original Medicare, meaning all Part B telehealth services must be covered. However, MA plans often offer expanded telehealth benefits that go beyond the scope of Original Medicare. These private plans have the flexibility to offer additional services, such as remote access to specialists or coverage for services delivered through audio-only platforms.
MA plans may incorporate different cost structures; for example, instead of the 20% coinsurance structure of Part B, an MA plan might charge a fixed co-pay for a virtual visit. The specific telehealth offerings and associated costs vary significantly depending on the individual plan and its provider network. Some MA plans may also cover services like remote patient monitoring, which allows providers to track health data from the patient’s home using various devices. Beneficiaries should consult their specific plan documents to understand their network restrictions and what additional virtual benefits are included.
Specific Rules for Mental Health and Behavioral Telehealth
Medicare has established distinct and often more permanent rules for mental health and behavioral telehealth services, recognizing the unique needs in this area. These services, which include psychotherapy, medication management, and substance use disorder treatment, can be received by the patient in their home without geographic restrictions on a permanent basis. A significant distinction for behavioral health is the permanent allowance for audio-only communication platforms for certain services.
While most general medical visits typically require both audio and video, mental health services can be delivered via two-way, real-time telephone calls under certain conditions. This is particularly helpful for beneficiaries who may lack access to reliable broadband internet or video-capable devices. Currently, there is no permanent requirement for an in-person visit within a certain timeframe following an initial mental health telehealth service, though this flexibility has been extended through January 30, 2026. Additionally, the list of eligible providers who can bill for these remote services has been expanded to include professionals like marriage and family therapists and mental health counselors.