The COVID-19 pandemic transformed Medicare telehealth from a limited rural-only benefit into a routine care delivery option for millions of beneficiaries. Congress and CMS made some of those expansions permanent while others continue to require periodic extensions. Knowing what is permanently available, what depends on legislative action, and how to use telehealth effectively under your specific coverage type helps you take advantage of one of the most convenient benefits Medicare now offers.
The telehealth expansion has genuinely helped clients who struggle with transportation, live in rural areas, or have mobility challenges. Mental health telehealth, now permanent, from your home, with any Medicare-enrolled provider, has opened access that did not exist before 2020. If you have not explored telehealth options for routine care, it is worth asking your doctor whether they offer it.
What was permanently expanded
Several telehealth expansions became permanent through legislation. Mental health telehealth services are now permanently available to Medicare beneficiaries regardless of where they live, the old rural-only restriction no longer applies to mental health care. Federally Qualified Health Centers and Rural Health Clinics can now permanently serve as the distant site for mental health telehealth visits. Audio-only telehealth (telephone visits without video) is permanently permitted for mental health services when the patient cannot use or does not have access to two-way audio-visual technology. These permanent changes reflect recognition that mental health access via telehealth reached populations that traditional in-person care was not serving.
What continues to require extension
Broader telehealth coverage for primary care visits, specialist consultations, and other services beyond mental health was established under COVID public health emergency waivers and has been extended repeatedly by Congress. Extensions through 2024 and into 2025 have maintained most telehealth coverage broadly, but this coverage is not permanently codified in the same way mental health telehealth is. Each legislative extension typically covers one to two years. Congress has shown consistent support for extending these provisions, but beneficiaries should verify current telehealth coverage status as political dynamics change.
How telehealth works under Original Medicare
For covered telehealth services under Original Medicare, the cost-sharing is the same as for in-person visits, the standard 20% Part B coinsurance after the deductible. You can use telehealth with any Medicare-enrolled provider who offers it, from your own home. You do not need to be at a medical facility to receive telehealth care. The provider must be Medicare-enrolled and provide services they are licensed to provide. Medigap covers the 20% telehealth coinsurance the same as it covers in-person office visit coinsurance.
How telehealth works under Medicare Advantage
Medicare Advantage plans must cover telehealth services at least as broadly as Original Medicare. Many Advantage plans go further, adding telehealth coverage for services and in ways not covered by Original Medicare, including $0 copay telehealth visits and broader telehealth provider access. If you have Medicare Advantage, review your plan's telehealth benefit specifically, it may be more generous than Original Medicare's baseline.
Questions about telehealth coverage under your specific plan?
Telehealth availability and what it costs you varies between Original Medicare, Medigap, and Advantage plans. I can help you understand what your coverage includes.
Book a Free CallAudio-only telehealth for patients without video capability
For patients who do not have smartphones, computers with cameras, or reliable internet capable of video calls, audio-only telephone visits remain a permanent option for mental health services. For other covered telehealth services, audio-only is permitted under the extended provisions as long as extensions remain in effect. This accessibility provision is particularly important for older Medicare beneficiaries who may have limited technology access or comfort with video platforms.
Finding telehealth providers
Most large primary care practices, health systems, and specialty groups now offer telehealth options for established patients. For mental health specifically, telehealth-first practices serving Medicare patients have expanded substantially. Your current physician's office likely has a telehealth scheduling option in their patient portal. For new providers, search for Medicare-accepting telehealth providers through your plan's directory or through telehealth platforms that verify Medicare provider enrollment.
Frequently asked questions