Most health insurance plans cover telemedicine, including Medicare, Medicaid, employer-sponsored plans, and marketplace plans. The specifics of what’s covered, how much you’ll pay, and whether your visit can be phone-only vary depending on your insurance type and the state you live in.
Medicare Telehealth Coverage
Medicare Part B covers a broad range of telehealth services, including video visits and, in many cases, phone-only appointments. Through December 31, 2027, you can use telehealth from anywhere in the U.S., including your home, with no geographic restrictions. Before the pandemic, Medicare limited telehealth mainly to patients in rural areas who traveled to a clinic to connect with a remote provider. Those restrictions have been lifted for now.
Covered services include depression screenings, outpatient psychotherapy, cardiac and pulmonary rehabilitation, diabetes self-management training, cognitive assessments, medical nutrition therapy, speech therapy, advance care planning, and caregiver training, among others. You pay the same cost-sharing as an in-person visit: after meeting your Part B deductible, you’re responsible for 20% of the Medicare-approved amount.
What’s Temporary vs. Permanent for Medicare
Some of these telehealth rules are locked in permanently, while others expire at the end of 2027 unless Congress acts. Understanding the difference matters if you rely on virtual care long term.
Permanent changes include telehealth for behavioral and mental health services from your home with no geographic limits, audio-only appointments for behavioral health, and the ability to see marriage and family therapists or mental health counselors via telehealth. These aren’t going anywhere.
The temporary rules, which last through 2027, cover everything else: non-mental-health telehealth from home, audio-only visits for non-behavioral services, and the waiver of the requirement that you see your mental health provider in person within six months of starting telehealth care. If these flexibilities aren’t renewed, Medicare telehealth could narrow significantly for non-mental-health visits starting in 2028.
Private Insurance and State Parity Laws
Most private insurers, including employer-sponsored and marketplace plans, cover telehealth. But whether they’re required to reimburse it at the same rate as an in-person visit depends on your state. Currently, 24 states and Puerto Rico have explicit payment parity laws that prevent insurers from paying less for a telehealth visit than they would for the same service delivered in person.
Some states go further. Montana, for example, prohibits insurers from applying higher deductibles, copays, or coinsurance to telehealth than to in-person care. States like California, Georgia, and Washington require payment parity but allow insurers and providers to negotiate different rates by contract. Louisiana has parity specifically for occupational and physical therapy, while Massachusetts mandates it for mental and behavioral health services.
If you live in a state without a parity law, your insurer can still cover telehealth but may reimburse at a lower rate or apply different cost-sharing. The practical effect: your copay for a virtual visit might differ from what you’d pay in the office. Check your plan’s summary of benefits or call the number on your insurance card to confirm your specific terms.
Medicaid Coverage
Every state Medicaid program covers some form of telehealth, though the details vary widely. Some states reimburse only live video visits, while others also cover store-and-forward services (where your provider sends images or records to a specialist for review later). Several states have been expanding eligibility and provider types. New Mexico, for instance, recently broadened its Telehealth Act to expand the definition of eligible providers and encourage both commercial insurers and Medicaid to incorporate more telehealth coverage. If you’re on Medicaid, your state’s program website will list which telehealth services are covered and whether phone-only visits qualify.
Mental Health Visits Get Extra Protection
Virtual mental health care has some of the strongest insurance protections of any telehealth service. The federal Mental Health Parity and Addiction Equity Act requires group health plans and insurers to apply the same financial requirements (copays, coinsurance) and treatment limitations (visit caps, prior authorization rules) to mental health and substance use disorder benefits as they do to medical and surgical benefits. That means your plan can’t impose stricter prior authorization for a virtual therapy session than it would for a comparable medical visit, and it can’t set tighter visit limits on mental health care.
Final rules issued in September 2024 reinforced these protections, explicitly stating that plans can’t use network composition standards or out-of-network reimbursement methods that are more restrictive for mental health services. Some states layer additional parity requirements on top of the federal law, making the protections even broader. The bottom line: if your plan covers in-person therapy, it generally must cover virtual therapy under comparable terms.
Phone-Only Visits
Not every telehealth visit requires a video connection. Medicare permanently covers audio-only appointments for behavioral and mental health services, as long as your provider has video capability but you either can’t use it or prefer not to. For non-behavioral services, audio-only Medicare coverage is available through 2027.
Private insurer policies on phone-only visits are less uniform. Some plans cover them the same as video visits; others require video for the appointment to qualify as telehealth rather than a simple phone consultation, which may be reimbursed at a lower rate or not at all. If video isn’t an option for you, confirm with your insurer before the appointment that a phone-only visit will be covered.
Cross-State Telehealth Visits
Insurance coverage for telehealth doesn’t automatically mean you can see any provider in any state. Providers generally must be licensed in the state where you’re located during the visit, not just where their office is. If you’re in Texas and your therapist is licensed only in New York, the visit may not be legally authorized, and your insurer may not pay for it.
Several workarounds exist. Multi-state licensure compacts allow participating providers to practice across member states without getting a separate license in each one. Some states offer telehealth registration pathways for out-of-state providers who hold a valid, unrestricted license elsewhere. A few states allow cross-border practice with neighboring states that share a common border. These arrangements are expanding, but they’re not universal. Before scheduling a visit with an out-of-state provider, verify that they’re licensed or registered to practice where you’ll be sitting during the appointment, and confirm with your insurer that the visit will be covered under your plan’s network rules.
How to Verify Your Coverage
The fastest way to confirm your telehealth benefits is to call the member services number on your insurance card and ask three questions: whether the specific type of visit you need (primary care, dermatology, therapy, etc.) is covered via telehealth, what your copay or coinsurance will be, and whether the provider you want to see is in-network for virtual visits. Many insurers also list telehealth benefits in the summary of benefits and coverage document available through your online member portal.
If you’re using a telehealth platform like Teladoc, Amwell, or a similar service, check whether your plan has a partnership with that platform. Some insurers offer discounted or fully covered visits through preferred telehealth vendors but apply standard out-of-network rates if you use a different service. Knowing this ahead of time can save you from an unexpected bill.