Most health insurance plans in the United States cover telehealth visits. Forty-one states and Washington, D.C., now require private insurers to cover telehealth the same way they cover in-person care, and both Medicare and Medicaid reimburse for virtual visits in all 50 states. The specifics of what’s covered, how much you’ll pay out of pocket, and which types of virtual visits qualify depend on your insurance type and where you live.
Private Insurance Coverage
Forty-three states and D.C. have laws on the books governing how private insurers handle telehealth, up from just 16 states in 2012. The vast majority of those states require what’s called “coverage parity,” meaning your insurer must cover a telehealth visit if it would cover the same service in person. Twenty-two states go further with “payment parity,” requiring insurers to reimburse providers at the same rate for virtual visits as they would for office visits.
Thirty-two states also have cost-sharing protections, which means your copay or coinsurance for a telehealth visit can’t be higher than what you’d pay for the same service in a clinic. In practice, many insurers charge lower copays for telehealth than for in-person visits as an incentive, but these laws ensure they can’t charge you more.
Beyond live video calls, 31 states require private insurers to cover store-and-forward technologies (where you send photos or information to a provider who reviews them later, common in dermatology and radiology), and 24 states mandate coverage for remote patient monitoring devices.
The Self-Funded Plan Exception
There’s one major gap. State telehealth laws only apply to state-regulated plans: individual marketplace plans, small group plans, and fully insured employer plans. They do not apply to self-funded employer plans, which cover more than 60% of workers who get insurance through their employer. Self-funded plans are regulated at the federal level, so your large employer’s plan may offer generous telehealth benefits or very limited ones, entirely at the employer’s discretion. If you’re unsure which type of plan you have, your benefits summary or HR department can tell you.
Medicare Telehealth Coverage
Medicare covers a broad range of telehealth services, and several pandemic-era expansions have been extended or made permanent. The most important distinction is between behavioral health services and everything else.
For mental health and substance use disorder care, Medicare has permanently removed geographic restrictions. You can receive therapy or psychiatric care by video or phone from your home, anywhere in the country, with no requirement to live in a rural area or visit a clinic first. Marriage and family therapists and mental health counselors are permanently eligible to provide these services. Audio-only phone calls are permanently covered for behavioral health when you don’t have access to or don’t want to use video.
For all other telehealth services, most of the same flexibilities are in place but on a temporary basis through December 31, 2027. That means until then, you can receive non-behavioral telehealth from home regardless of where you live, use audio-only visits, and see an expanded range of provider types. The requirement for an in-person visit within six months of starting behavioral telehealth has also been waived through the same date.
Medicaid Coverage by State
Every state Medicaid program reimburses for some form of live video telehealth. Forty-six states and D.C. also cover audio-only phone visits, though often with limitations on which services qualify. Forty state Medicaid programs reimburse for store-and-forward services. Most states now allow your home to serve as the location where you receive telehealth, and many cover remote patient monitoring as well.
Because Medicaid is administered state by state, the specific services covered, the types of providers who can bill, and the copay requirements vary. Your state Medicaid office or managed care plan can confirm what’s included in your benefits.
Mental Health Visits Get Extra Protection
Federal law provides an additional layer of coverage for virtual mental health care. The Mental Health Parity and Addiction Equity Act requires that group health plans and insurers cannot impose stricter financial requirements or treatment limits on mental health and substance use disorder benefits than they impose on medical and surgical benefits. That includes copays, coinsurance, visit limits, prior authorization requirements, and network restrictions.
In practical terms, this means if your plan covers in-person therapy with a $30 copay and no prior authorization, it generally cannot charge a higher copay or add prior authorization for the same therapy delivered by telehealth. The parity requirements also cover less obvious restrictions like geographic limits and standards for which providers are included in a network.
What Telehealth Typically Doesn’t Cover
Insurance coverage for telehealth applies to services that can reasonably be delivered remotely. Visits that require a physical exam, lab work, imaging, or hands-on procedures won’t be covered as telehealth because they can’t actually be performed virtually. Common examples include annual physicals that require blood pressure readings and lab panels, surgical consultations that need a physical assessment, and emergency care.
Some plans also limit which telehealth platforms or providers you can use. If you use a direct-to-consumer telehealth app that isn’t in your plan’s network, you may pay out-of-network rates or get no coverage at all. Using your plan’s own telehealth portal or confirming that a provider is in-network before booking is the simplest way to avoid surprise bills.
How to Verify Your Telehealth Benefits
The fastest way to confirm your coverage is to call the member services number on the back of your insurance card and ask three specific questions: whether telehealth visits are covered under your plan, what your copay or coinsurance will be for a virtual visit, and whether you need to use a specific platform or provider network. Many insurers also list telehealth benefits in the summary of benefits and coverage document available through your online account.
If you have a high-deductible health plan paired with a health savings account, telehealth visits typically count toward your deductible the same way in-person visits do. Some employers have added pre-deductible telehealth benefits as a perk, covering virtual visits at a flat copay even before you meet your deductible. This varies by plan, so it’s worth checking.
For Medicare beneficiaries, the simplest approach is to confirm with your provider’s office that they bill Medicare for telehealth. Most providers now do, and the billing process is handled on their end. You’ll pay your standard Part B cost-sharing for the visit.