Medicare’s telehealth coverage just changed dramatically in October 2025, and if you’ve been relying on virtual visits from home, you need to know what services you can still access and which ones now require you to travel.
Key Takeaways
- Medicare Part B covers telehealth services including routine consultations, mental health counseling, urgent care, and prescription management with standard 20% cost-sharing after meeting the annual deductible.
- Coverage changes took effect October 1, 2025 – most telehealth services now require rural locations, though mental health services can still be received at home.
- Medicare Advantage plans must cover all Original Medicare telehealth benefits and many offer additional telehealth services as supplemental benefits.
- Telehealth fraud schemes are increasing – be wary of unsolicited calls offering free services or requesting personal information without legitimate appointments.
- Understanding current restrictions helps beneficiaries who rely on telehealth services navigate the policy changes that took effect in 2025.
The pandemic transformed how Medicare beneficiaries access healthcare, with telehealth services becoming a lifeline for millions. Understanding current coverage and recent changes helps ensure continued access to medical care from the comfort of home.
Medicare Part B Covers Telehealth Services
Medicare Part B provides coverage for telehealth services, allowing beneficiaries to receive medical care through video or phone consultations with qualified healthcare providers. These services function as complete medical visits, not just quick check-ins, and carry the same therapeutic value as in-person appointments.
The coverage extends beyond basic consultations to include specialized treatments and follow-up care. For detailed information about Medicare coverage options and telehealth benefits, Medicare.org provides resources to help beneficiaries navigate their healthcare choices.
Current telehealth flexibilities that allowed beneficiaries to receive covered services from any location in the United States, including their homes, expired on September 30, 2025. This expanded access proved particularly valuable for individuals with mobility limitations, transportation challenges, or those living in areas with limited healthcare provider availability.
What Telehealth Services Are Covered by Medicare
Medicare’s telehealth coverage includes a wide range of medical services designed to meet diverse healthcare needs. Understanding these covered services helps beneficiaries make informed decisions about their care options.
1. Routine consultations and follow-up visits
Primary care visits, specialist consultations, and post-surgical follow-ups represent core telehealth services under Medicare coverage. These appointments allow providers to assess symptoms, review treatment progress, and adjust care plans without requiring office visits. Lab test result discussions and routine health monitoring also fall under this category.
2. Mental health counseling and therapy
Medicare covers psychotherapy sessions, behavioral health counseling, and substance abuse treatment through telehealth platforms. Mental health professionals can provide individual therapy, group sessions, and psychiatric evaluations using approved video technology. These services have shown particular success in maintaining continuity of care for beneficiaries with ongoing mental health needs.
3. Urgent care for minor conditions
Non-emergency medical issues like colds, coughs, stomach aches, and minor injuries can be addressed through telehealth consultations. Providers can assess symptoms, prescribe medications, and determine whether in-person care is necessary. This coverage helps reduce emergency department visits for conditions that don’t require immediate hands-on treatment.
4. Prescription management and medication reviews
Medication management consultations allow providers to review current prescriptions, assess side effects, and make necessary adjustments to treatment regimens. These appointments are particularly valuable for beneficiaries managing multiple chronic conditions requiring regular medication monitoring and dosage modifications.
5. Specialized treatments for stroke and ESRD
Medicare covers specialized telehealth services for acute stroke diagnosis, evaluation, and treatment, including services provided through mobile stroke units. Additionally, monthly End-Stage Renal Disease (ESRD) visits for home dialysis patients are covered regardless of geographic location, ensuring continuous monitoring of this critical condition.
Telehealth Costs Under Medicare
Understanding the financial aspects of telehealth services helps beneficiaries budget for their healthcare needs and avoid unexpected costs.
Original Medicare Part B cost-sharing rules
Telehealth services under Original Medicare follow standard Part B cost-sharing structure. After meeting the annual Part B deductible, which is $257 in 2025, beneficiaries typically pay 20% of the Medicare-approved amount for telehealth services. This cost-sharing remains consistent with in-person visits, ensuring no financial penalty for choosing remote care options.
Providers who accept Medicare assignment cannot charge more than the Medicare-approved amount, protecting beneficiaries from surprise billing. Some providers may choose to reduce or waive cost-sharing for telehealth visits, particularly during public health emergencies, though this flexibility varies by practice and circumstances.
Medicare Advantage plan differences
Medicare Advantage plans must cover all telehealth services included in Original Medicare but may offer different cost structures. Many plans provide lower copayments for telehealth visits or include them as part of their benefits package. Contact individual Medicare Advantage plans directly to understand specific telehealth costs and coverage details, as these can vary significantly between plans and geographic areas.
Coverage Changes That Took Effect October 2025
Policy modifications that took effect on October 1, 2025, have substantially altered telehealth access for many Medicare beneficiaries. Understanding these changes enables proactive healthcare planning.
Many telehealth flexibilities ended
The temporary telehealth flexibilities implemented during the COVID-19 pandemic expired on September 30, 2025. These flexibilities previously allowed beneficiaries to receive most telehealth services from any location, including their homes, regardless of geographic area. After this date, traditional geographic and site-of-service restrictions have largely returned.
Return to rural area requirements for most services
As of October 1, 2025, most Medicare telehealth services require beneficiaries to be physically located in an office or medical facility within a designated rural area. This represents a return to pre-pandemic restrictions that limited telehealth access based on geographic criteria and approved originating sites.
The rural area requirement means beneficiaries in urban and suburban locations have lost access to most telehealth services unless they travel to approved rural healthcare facilities. This change could significantly impact access for beneficiaries who relied on home-based telehealth services during the pandemic period.
Mental health and select services remain available at home
Despite the return to restrictive policies, certain telehealth services continue to be available from home locations after October 1, 2025. Mental health and behavioral health services, including substance abuse treatment, can still be received at home regardless of geographic location.
Additionally, monthly ESRD visits for home dialysis patients and services for stroke diagnosis, evaluation, and treatment remain accessible from any location. These exceptions recognize the critical nature of these services and the practical challenges of requiring site-specific care.
How Medicare Advantage Plans Handle Telehealth
Required coverage matching Original Medicare
All Medicare Advantage (MA) plans must cover the same telehealth services included under Original Medicare Part B. This ensures a consistent baseline: routine consultations, mental health visits, prescription management, and specialty care like stroke and ESRD telehealth services. This includes Medicare Special Needs (SNP) plans, too.
Expanded telehealth benefits offered by many plans
Where Medicare Advantage really stands out is in how plans use telehealth as a competitive differentiator. Many carriers have moved far beyond the basic requirements, offering expanded benefits that make telehealth easier, cheaper, and more convenient:
- $0 copays for virtual visits – Several large carriers, including Humana and Aetna, advertise zero-cost telehealth visits with in-network doctors.
- 24/7 urgent care access – UnitedHealthcare and others include virtual urgent care platforms, letting members connect with a clinician any time of day or night without leaving home.
- Virtual primary care options – Some plans allow members to select a virtual PCP for ongoing management of chronic conditions, annual check-ins, and preventive care.
- Specialty telehealth services – Plans increasingly cover remote dermatology, cardiology, behavioral health, and even physical therapy consults.
- Remote monitoring programs – Certain MA plans integrate devices like blood pressure cuffs, glucose monitors, or wearables, feeding data directly to providers for proactive care.
- Nurse advice lines and wellness telecoaching – Many plans include 24/7 nurse lines, nutrition counseling, or chronic condition coaching delivered virtually.
Why this matters
For many beneficiaries, these extras mean telehealth is not just preserved after the October 2025 Part B cutbacks — it’s actually expanded under MA. Beneficiaries in urban or suburban areas who may have lost access to home-based Part B telehealth services can often regain that convenience through an MA plan.
Choosing a Medicare Advantage plan with strong telehealth benefits can be a game-changer, especially for beneficiaries with limited mobility, chronic health needs, or a preference for the convenience of home-based care.
Some Popular Medicare Advantage Plans that Cover Telehealth
| Wellcare By Allwell | |
|---|---|
| Wellcare Dual Liberty Sync (H5590-008-0) | |
| Optimum HealthCare, Inc. | |
| Optimum Diamond Rewards (H5594-028-0) | |
| Anthem HealthKeepers | |
| Anthem Medicare Advantage (H3447-042-1) | |
| Anthem Medicare Advantage (H3447-038-1) | |
| Anthem Medicare Advantage (H3447-042-4) | |
Protecting Yourself from Telehealth Fraud
The expansion of telehealth services has unfortunately created new opportunities for fraudulent schemes targeting Medicare beneficiaries. Recognizing common fraud patterns helps protect personal information and Medicare benefits.
1. Unsolicited calls offering free services
Be wary of unexpected phone calls from unknown providers offering free telehealth consultations, prescription drugs, or cash payments in exchange for personal information. Legitimate healthcare providers typically don’t make unsolicited marketing calls or offer financial incentives for appointments. These callers often seek Medicare information to submit fraudulent claims for services never provided.
2. Requests for personal information without appointments
Fraudsters may call claiming to verify pain symptoms, family medical history, or other health information without a scheduled appointment or established patient relationship. Legitimate providers only collect health information during official appointments or as part of established care relationships. Never provide Medicare numbers, Social Security numbers, or health information to unsolicited callers.
3. Offers for unnecessary medical equipment
Some telehealth fraud schemes involve offering durable medical equipment like braces, orthotics, or genetic testing kits that beneficiaries didn’t request or don’t need. These schemes often involve kickbacks and false billing practices, with criminals using brief telehealth consultations to justify Medicare claims for expensive equipment.
If suspicious telehealth fraud is suspected, contact 1-800-MEDICARE immediately or report concerns to the local Senior Medicare Patrol. Enforcement actions, including charges filed in a $110 million telemedicine fraud scheme in Massachusetts in February 2024, demonstrate the serious financial impact of these criminal activities on the Medicare program.
Planning Healthcare Access After Policy Changes
With many services now subject to rural-area requirements as of October 1, 2025, beneficiaries should evaluate their healthcare needs and consider alternative arrangements.
Consider scheduling telehealth appointments for routine consultations and follow-up care that may now be geographically restricted. Work with healthcare providers to understand how the changes affect ongoing care and discuss alternative arrangements for continued access.
Mental health services continue to be available from home, making this an opportune time to establish care relationships with mental health providers if needed. Additionally, beneficiaries should review their Medicare Advantage options during annual enrollment periods, as these plans may offer expanded telehealth benefits that provide greater access than Original Medicare after the policy changes.
Frequently Asked Questions About Medicare Telehealth
Does Medicare cover telehealth services?
Yes. Medicare Part B covers a range of telehealth services, including routine consultations, mental health counseling, urgent care visits, and prescription management. After meeting the annual Part B deductible ($257 in 2025), beneficiaries typically pay 20% of the Medicare-approved amount.
Does Medicare cover telemedicine and virtual visits from home?
Most telehealth flexibilities that allowed beneficiaries to access care from home ended on September 30, 2025. Starting October 1, 2025, Medicare generally requires beneficiaries to be in a rural location and at an approved originating site. Mental health services are the major exception and can still be provided at home.
What telehealth services are still covered under Medicare?
Medicare covers telehealth for office visits, psychotherapy, prescription management, lab result discussions, follow-up care, and certain specialty treatments. Services for acute stroke and monthly ESRD visits remain covered regardless of geographic location. Behavioral health services, including counseling and substance abuse treatment, continue to have expanded telehealth access.
Do Medicare Advantage plans cover telehealth?
Yes. All Medicare Advantage (MA) plans must cover the same telehealth services as Original Medicare, but many go further. MA plans often include $0 copays for virtual visits, 24/7 urgent care access, virtual primary care, expanded specialty telehealth, and even remote monitoring devices. Coverage varies by plan, so it’s important to compare options during enrollment.
How much do I pay for telehealth visits under Medicare?
Under Original Medicare, beneficiaries pay the annual Part B deductible ($257 in 2025) and then 20% of the Medicare-approved amount. Medicare Advantage plans may offer lower copays or waive them entirely for certain telehealth visits, depending on the plan’s design.
Can I use telehealth for mental health care?
Yes. Mental health telehealth services remain accessible from home regardless of geographic location. Audio-only visits are allowed, and services include therapy, counseling, and psychiatric evaluations. However, as of October 1, 2025, beneficiaries must have an in-person visit within six months of the first telehealth session and at least once every 12 months thereafter.
How can I protect myself from telehealth fraud?
Be cautious of unsolicited calls offering free services or requesting personal information. Legitimate providers do not cold-call Medicare beneficiaries. Never give out your Medicare number to unknown callers, and report suspected fraud by calling 1-800-MEDICARE or contacting your local Senior Medicare Patrol.