I live in a rural area with limited specialists and am interested in telehealth options. How does Medicare cover virtual visits for someone in my location?

Answered by 9 licensed agents

Original Medicare does cover telehealth visits and I will cut and paste information regarding telehealth visits as it relates to original Medicare here

However…

I want to bring to your attention the importance of comparing original Medicare, Medicare Supplement or Medigap and then Medicare Advantage plans, if you live in a rural area and need to access telehealth options.

Original Medicare, as mentioned above, does include telehealth, however it is limited in its scope, therefore because Medigap or Medicare Supplements simply work WITH Original Medicare…Medicare supplements or Medigap policies are also limited in their scope.

You can think about Medigap or Medicare Supplement and original Medicare like puzzle pieces. They work together, so if original Medicare cover something, Medicare supplement is required to come in and pick up what original Medicare does not cover at whatever benefit level you have on your plan.

Medicare advantage plans, however, provide enhanced benefits for telehealth so…oddly…if you’re living in a rural area, a Medicare advantage plan may offer you more options for telehealth that you would otherwise not have access to if you were simply on original Medicare and Medigap.

The reason I say “oddly” is because Medigap and original Medicare are often said to give you the most freedom and flexibility however, where you live and the network access that you have has a larger impact on the concept of freedom and flexibility as it relates to telehealth in this case.

This is why it’s so important to work with a broker because your broker can take a look at, not only, what is the “best option” for most people, but what really is the “best option for you.”

I hope you guys are having a great experience with your Medicare broker and if you’re not simply reach out!

Answered by Alison Hummel on April 30, 2025

Agent Licensed in NJ & PA

Answered by Alison Hummel Medicare Insurance Agent
Most Virtual visits are available at $0 costs for the member, depending on the Medicare Plan. If Telehealth is available, that benefit will be listed in the Evidence of Coverage

Answered by Melonie Wood on April 8, 2025

Agent Licensed in FL & AL

Answered by Melonie Wood Medicare Insurance Agent
As long as the Doctor is willing to do virtual visitations and then bill Medicare, it will be covered as a standard visitation from Medicare Part B. It is a wonderful benefit of technology that can save you much time and costs!

Answered by Norman Smith on April 6, 2025

Agent Licensed in FL & PA

Answered by Norman Smith Medicare Insurance Agent
In general, Medicare Part B covers a variety of telehealth services, including virtual visits with doctors and other healthcare professionals, regardless of whether you live in a rural or urban area. Specifically, for beneficiaries in rural areas, telehealth is covered when accessed from a rural health clinic, critical access hospital, federally qualified health center, or certain other designated facilities. See what follows for a more detailed breakdown:

Coverage:

Medicare Part B covers telehealth services, which include virtual check-ins, virtual evaluations, and other virtual visits.

Location:

For telehealth services, you can be located at home or in a healthcare facility when receiving the service.

Rural Areas:

In rural areas, telehealth is covered if accessed from a qualifying location, such as a rural health clinic, critical access hospital, or federally qualified health center.

Geographic Restrictions:

While some telehealth services may have geographic restrictions, many are now covered regardless of location. For example, behavioral/mental health services can be delivered to patients in their homes, even in urban areas.

Out-of-Pocket Costs:

You will typically have to pay a Part B deductible and 20% coinsurance for telehealth services, as with other Medicare-covered services.

Medicare Advantage:

If you have a Medicare Advantage plan, you'll need to check with your specific plan provider for details on coverage and out-of-pocket costs.

Answered by Fred Manas on May 7, 2025

Agent Licensed in NY, CT, DC & 7 other states

Answered by Fred Manas Medicare Insurance Agent
Medicare covers virtual doctor visits. Part B offers a range of telehealth services including virtual visits, consultations, and some mental health services. These services are not limited to just rural areas.

Answered by Tony Hardwick on April 28, 2025

Agent Licensed in GA, AZ, CA & 15 other states

Answered by Tony Hardwick Medicare Insurance Agent
Medicare covers E-visits or telehealth using an online patient portal. To get an E-visit, you must request one with your doctor. You will 20% of the approved Medicare amount for your doctor's or other provider's services. The Part B deductible applies.

Answered by Dominic Javier on April 29, 2025

Broker Licensed in TX

Answered by Dominic Javier Medicare Insurance Agent
You can get telehealth services from your home until 10/1/2025, after that, if in a rural area, you will have to be in a medical office to receive telehealth services (After 10/1/2025 there will be certain services you can still get telehealth for). I advise checking with your Dr beforehand to ensure Medicare will cover the services you need.

Medicare.gov & the Medicare & You book have a lot of information that may be useful to you.

Answered by Jessica Breland on April 9, 2025

Broker Licensed in LA

Answered by Jessica Breland Medicare Insurance Agent
Virtual visits are covered by many plans, but it is still necessary to review plans in your area to ensure your plan has telehealth benefits for your providers.

Answered by Jennifer Osborne on April 9, 2025

Broker Licensed in KY, FL, IL, IN, NE & OH

Answered by Jennifer Osborne Medicare Insurance Agent
Most Medicare Advantage plans have telehealth included in their plan. Please feel free to reach out and I can help answer your question further!

Answered by Barbara Bolden on April 28, 2025

Agent Licensed in NC, NY & SC

Answered by Barbara Bolden Medicare Insurance Agent

Tags: Coverage

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