Telehealth for seniors: Medicare coverage and making video visits easier

Yes, Medicare covers telehealth from home, and Congress has extended that coverage through December 31, 2027. In most cases you pay what you would for an office visit, and you can join from a tablet, a computer, or for many services a plain phone call. The catch is that coverage depends on the clinician billing Medicare, and the setup is easier with a little preparation, which this guide covers.

What Medicare covers right now

Before 2020, Original Medicare paid for telehealth mainly when a patient lived in a rural area and traveled to a clinic or hospital for the video connection. During the COVID-19 public health emergency, Congress and CMS removed those limits. You could be seen from your own home, wherever you lived, and many services could be delivered by phone if you did not have video.

Those flexibilities were extended several times. They briefly lapsed during the federal government shutdown in the fall of 2025, then were restored. The Consolidated Appropriations Act, 2026, signed on February 3, 2026, extended them through December 31, 2027. Under the current rules:

• Home counts. You can have a covered telehealth visit from home, not only from a clinic.
• Location does not matter. The old rural-only requirement is suspended.
• Audio-only is allowed for many services, which helps if video is hard for you.
• Mental health visits by telehealth are permanently covered from home. An in-person visit requirement for them has been delayed again and is not currently being enforced.

What it costs you

Under Original Medicare, covered telehealth visits are generally treated like office visits. Once you meet the Part B deductible, you typically pay 20 percent of the Medicare-approved amount. A Medigap supplement policy may pick up some or all of that, depending on your plan.

Medicare Advantage plans must cover what Original Medicare covers, and many offer extra telehealth benefits on top, sometimes with lower copays. They also usually have networks. Check that the clinician is in your plan's network before booking.

When Medicare will not pay

Coverage depends on the clinician as much as the service.

The clinician must bill Medicare. Some physicians have formally opted out of Medicare. If you see one, they must have you sign a private contract first, and neither of you can bill Medicare for that care. Others simply run cash-pay practices. Always ask before the visit whether Medicare will be billed.

The service must be covered. Medicare does not pay for medical cannabis certification. Coverage of weight management medication has historically been very limited under Part D, and it has been changing, so ask your Part D plan what applies to you. Many services offered by specialty telehealth practices fall outside what Medicare pays for.

Aone is a cash-pay practice and does not bill insurance. If you have Medicare, ask before booking how payment would work for the service you are interested in, so there are no surprises. Our post on how insurance and telehealth fit together explains the general picture.

Making video visits easier

Plenty of people in their 70s and 80s use video visits comfortably. Plenty of others find the first one stressful. A few preparations make a large difference.

Pick the right device

A tablet or laptop is easier than a phone for most people. The screen is larger, the camera can sit still on a table, and your hands are free. If a phone is all you have, prop it against something steady at eye level.

Do a test run

Ask the practice for its video link or app a day ahead and open it once. Check that the camera and microphone work and that you know where the "join" button is. Many practices will do a short tech check with you if you ask.

Help with hearing and sight

• Turn the volume all the way up, or use headphones. Many hearing aids can connect to a tablet or phone by Bluetooth.
• Turn on captions if the platform offers them.
• Increase the text size in your device settings.
• Sit facing a window or lamp so the clinician can see your face clearly.

Invite a helper

A family member or caregiver can sit with you, join from another location, or just help you log on. Tell the clinician who is there at the start of the visit. If you want them to be able to talk to the practice on your behalf later, ask what form you need to sign.

Have your information ready

Gather your pill bottles, including vitamins and supplements, so you can read labels or hold them up to the camera. Write down your questions. If you have a home blood pressure cuff, scale or glucose meter, take a reading that morning. Our guide on how to prepare for a telehealth visit has a fuller checklist.

Have a backup

Make sure the practice has a phone number to call you if the video drops. Keep your phone charged and nearby.

What telehealth is and is not right for

Telehealth works well for medication reviews, discussing test results, follow-up for chronic conditions and mental health care. It cannot replace a physical examination, and it is the wrong choice for anything sudden or severe. Chest pain, trouble breathing, signs of stroke such as face drooping, arm weakness or speech difficulty, or a serious fall need 911, not a video visit. Our guide to telehealth, urgent care or the ER covers how to choose.

For older adults in rural areas, telehealth can save long drives in bad weather. We cover that side in telehealth in rural Michigan.

Questions patients ask us

Does Medicare cover telehealth visits from home?

Yes. Under current law, Medicare covers many telehealth services delivered to you at home, wherever you live in the country. The Consolidated Appropriations Act, 2026, extended these flexibilities through December 31, 2027. Coverage after that date depends on further action by Congress, so check Medicare.gov or call 1-800-MEDICARE for current rules.

How much does a Medicare telehealth visit cost?

Under Original Medicare, covered telehealth visits are generally treated like office visits. After you meet the Part B deductible, you typically pay 20 percent of the Medicare-approved amount. A Medigap policy may cover some or all of that. Medicare Advantage plans set their own copays, and some charge less for telehealth.

Does Medicare cover phone-only visits?

For many services, yes. Under the current flexibilities, audio-only visits are allowed when video is not possible or you do not consent to video, and audio-only mental health visits have their own coverage rules. Ask the practice whether your specific visit can be done by phone and whether it will be billed to Medicare.

Will Medicare pay for any telehealth practice?

No. Medicare pays only when the clinician bills Medicare and the service is covered. Physicians who have formally opted out of Medicare must have you sign a private contract first, and neither of you can bill Medicare. Some practices are simply cash-pay. Always ask before your visit whether Medicare will be billed.

Does Medicare cover medical cannabis evaluations?

No. Medicare does not pay for medical cannabis certification or for cannabis products. If you are interested in a state medical cannabis program, expect to pay for the evaluation yourself. Check your state program's rules on registration fees, which are separate from the cost of the evaluation.

Are telehealth benefits different with Medicare Advantage?

They can be. Medicare Advantage plans must cover what Original Medicare covers, and many add extra telehealth benefits, sometimes with lower copays or access to a plan's own virtual care service. Most also have networks, so check that a clinician is in network before booking. Your plan's Evidence of Coverage spells out the details.

Can a family member join my telehealth visit?

Yes. A family member or caregiver can sit with you, join from another location if the platform allows, or help you log in. Tell the clinician who is present at the start. If you want that person to be able to speak with the practice for you later, ask what authorization form you need to sign.

What is the easiest device for a video visit?

For most people, a tablet or laptop is easier than a phone. The screen is larger, the camera can rest on a table, and your hands are free for pill bottles or notes. If you use a phone, prop it up at eye level. Ask the practice for a test link the day before.

How can I hear better during a video visit?

Turn the device volume all the way up, use headphones, or connect your hearing aids by Bluetooth if they support it. Turn on captions if the platform offers them, and reduce background noise from televisions or radios. Ask the clinician to slow down or repeat anything you miss. It is a reasonable request.

Where can I get free help understanding my Medicare telehealth benefits?

Your State Health Insurance Assistance Program, known as SHIP, offers unbiased one-on-one Medicare counseling at no charge. In Michigan it is MMAP, in Illinois it is SHIP through the Department on Aging, and in California it is HICAP. You can also call 1-800-MEDICARE for help with coverage questions.