Does Medicare pay for telehealth visits with specialists, or is it limited to primary care?

Question

Steve Houchens · Accepted Answer

Yes many do. It’s important to know the limitations involved for your specific plan, so be sure to ask questions and check those situations before you make a choice on your plan if that’s an important issue for you.

Answered by Steve Houchens on April 10, 2025

Agent Licensed in KY & TN

Answered by Steve Houchens Medicare Insurance Agent

Robert Fracchia · Answer

YES....   there is a $0 copay for virtual visits with primary care, specialist and behavioral health providers

Jay Carlton · Answer

Medicare's Part B allows for you to do telehealth with both a Primary Care and a Specialist. They are covered in the same way as if you wast to go in person.

Steven Bleicher · Answer

I am sorry to say that this year, some plans eliminated telehealth visits since nobody was using them. Please check your own plan by calling the toll-free number on the back of your plastic card.

Bruce Kern · Answer

IT DEPENDS ON WHICH MEDICARE iNSURANCE PLAN YOU ARE ON.
Weather you are on Medicare Advantage or a Medicare supplement Plan.

Kathy Adams · Answer

I believe original Medicare Parts A and B doesn't cover telehealth, BUT if you're on Medicare Advantage Plan,  this coverage is covered

Fred Manas · Answer

Yes, Medicare does cover telehealth visits with specialists, not just primary care. Original Medicare Part B covers a wide range of telehealth services, including those provided by specialists, under the same rules as in-person visits. These services can be accessed remotely through two-way interactive audio and video, and include things like physician consultations, office visits, and mental health services. 
Elaboration:
Expanded Coverage:
During the COVID-19 pandemic, Medicare expanded its telehealth coverage, allowing beneficiaries to receive services in their homes and without geographic restrictions. This expansion has since been extended. 
Geographic Restrictions:
While some restrictions on location exist for certain services, many telehealth visits are now available regardless of where the beneficiary is located, as long as they are within the US. 
Type of Services:
Medicare Part B covers a variety of telehealth services, including:
Primary care and other triage visits 
Specialist consultations 
Psychotherapy and mental health services 
Occupational therapy and physical therapy 
Provider Types:
Many providers can offer telehealth services, including doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers. 
Cost-Sharing:
Medicare beneficiaries typically pay a 20% coinsurance and the Part B deductible for telehealth visits, similar to in-person visits.

Gary Henderson · Answer

Yes, Medicare does cover telehealth visits, both through Original Medicare (Parts A and B) and Medicare Advantage plans. Medicare Part B covers a range of telehealth services, including routine office visits, consultations, and certain mental health services

Answered by Gary Henderson on April 19, 2025

Agent Licensed in TX, AK, AL & 46 other states

Answered by Gary Henderson Medicare Insurance Agent

Barbara Barnes, CMIP® · Answer

Medicare pays for Medical visits with primary care doctors and specialists, as long as they’re medically necessary.

Rachael Metcalf · Answer

Medicare does not. But your Medicare Advantage plan will have that benefit included. It is not just limited to primary care.  (covers, PCP, spec, rehab and mental health therapy)

Dominic Javier · Answer

To get an E-visit, Telehealth, you must request one with your doctor or other provider. You will pay the 20% of the Medicare-approved amount for your doctor's or other provider services. The Part B deductible applies. The E-visits allow you to talk with your provider using an online patient portal.

Answered by Dominic Javier on April 22, 2025

Broker Licensed in TX

Answered by Dominic Javier Medicare Insurance Agent

Kimberly Hargis · Answer

Some Medicare Advantage plans have telehealth for specialists.  It just depends on the insurance carrier.  You could check it out on Medicare.gov website.

Rodolfo Rojas · Answer

It depends on what type of Medicare do you. If you have Medicare Advantage-C- yes. 
If you are in original Medicare, which is A and B, depends on where you go. You may have 20% coinsurance. An agent would have to do a need analysis to provide you with correct information. 
If you have MediGap, you are covered.

Britania James · Answer

Many Medicare Advantage plans cover telehealth visits. It depends on the specific plan. Review the Summary of Benefits for your specific plan for coverage of telehealth.

Dalton Johnson · Answer

When and if your provider or Dr accepts assignment, then Medicare will pay its share for a virtual visit. If you have a supplement or advantage plan most of these also have virtual care benefits.

Shawn Watzlawick · Answer

Medicare covers certain telehealth services you get from a doctor or other health care provider who’s located elsewhere using technology to communicate with you in real time. Telehealth can provide many services that generally occur in-person, including office visits, psychotherapy, consultations, and certain other medical or health services. 

Through December 31, 2024, you can get telehealth services at any location in the U.S., including your home. After this period, you must be in an office or medical facility located in a rural area to get most telehealth services. However, you’ll still be able to get certain telehealth services without being in a rural area.

 They include: 
• Monthly End-Stage Renal Disease (ESRD) visits for home dialysis 
• Services for diagnosis, evaluation, or treatment of symptoms of an acute stroke wherever you are, including in a mobile stroke unit 
• Services to treat a substance use disorder or a co-occurring mental health disorder or for the diagnosis, evaluation, or treatment of a mental health disorder, including in your home 
• Behavioral health services (also called mental health services), including in your home 
• Diabetes self-management training 
• Medical nutrition therapy 

You pay 20% of the Medicare-approved amount for your doctor or other health care provider or practitioner’s services. The Part B deductible applies. For most of these services, you’ll pay the same amount you would if you got the services in person.