Medicare Telehealth Coverage in 2026: What Families Actually Need to Know

If your parent is on Medicare and uses telehealth — or you've been meaning to set it up — 2026 is a year you need to pay attention to. The temporary telehealth flexibilities that expanded during the pandemic have been extended, modified, and debated in Congress for years, and the current rules have real implications for whether your parent can keep seeing their doctor from home.

This isn't a policy briefing. It's a plain-English breakdown of what matters for families managing an aging parent's healthcare remotely — the coverage questions, the cost surprises, and the things nobody tells you until the bill arrives.

The Short Version: What Changed

Congress extended Medicare's expanded telehealth flexibilities through January 30, 2026, as part of the continuing resolution passed in late 2025. This means that the pandemic-era rules allowing beneficiaries to receive telehealth from home (rather than requiring them to be at a qualifying "originating site" like a rural clinic) remain in effect — for now.

But "for now" is the operative phrase. These flexibilities have been extended in short bursts since 2020, and every extension comes with uncertainty. If you're relying on telehealth for your parent's routine care, you need to understand what's actually guaranteed and what could change.

What Medicare Telehealth Actually Covers

Under the current rules, Medicare Part B covers telehealth visits for most services that would normally be covered in person. That includes:

  • Office visits with primary care doctors and specialists
  • Mental health appointments including therapy and psychiatry
  • Chronic care management check-ins for conditions like diabetes, heart disease, and COPD
  • Post-surgical follow-ups where a physical exam isn't strictly necessary
  • Medication management consultations

The key requirement is that the visit must use real-time audio and video. A phone-only call may be covered in some circumstances, but Medicare generally requires a video component for the visit to qualify as "telehealth" rather than a basic phone consultation.

The "Originating Site" Rule — Why It Matters

Before the pandemic, Medicare only paid for telehealth if the patient was sitting in a qualifying medical facility (a "distant site") in a rural area. Your parent's living room didn't count.

The pandemic waivers removed this restriction, allowing beneficiaries to receive telehealth from home regardless of where they live. The 2026 extension keeps this waiver in place, which is critical — because most families using telehealth are doing so precisely because getting to a clinic is the problem.

If these waivers expire without being made permanent, your parent would technically need to travel to an approved site to receive a "telehealth" visit. That defeats the entire purpose for homebound or mobility-limited seniors.

What You'll Actually Pay

Medicare telehealth visits are generally billed the same as in-person visits. That means:

  • Part B covers 80% of the Medicare-approved amount after the annual deductible is met
  • Your parent pays the remaining 20% as coinsurance (unless they have a Medigap or Medicare Advantage plan that covers it)
  • Medicare Advantage plans may have different copay structures — some charge $0 for telehealth, others charge the same as an office visit

The practical takeaway: a telehealth visit isn't free. Your parent will likely see a copay or coinsurance charge, typically ranging from $15 to $40 depending on their plan. This is still cheaper and easier than driving to the office, but it surprises families who assumed "video visits are free."

One important exception: mental health visits conducted via telehealth require at least one in-person visit with the provider within the first six months of treatment, and at least annually thereafter. This is a patient safety requirement, not a cost issue, but it means you can't go fully remote for psychiatric care.

The Prescribing Question

For parents who take controlled medications — pain management, anxiety medications, ADHD drugs, or sleep aids — the telehealth prescribing rules matter enormously. The DEA extended its telemedicine prescribing flexibilities through 2026, meaning providers can continue prescribing Schedule II-V controlled substances via telehealth without an initial in-person exam.

This is a big deal for families managing chronic pain or anxiety in aging parents. Without this flexibility, your parent would need to physically visit the prescriber before any telehealth-based refills — a significant barrier for mobility-limited seniors.

What Could Change (and When to Worry)

The biggest risk is that Congress doesn't extend these flexibilities beyond their current expiration. Here's what to watch:

  • Legislative deadlines — The current extension runs through January 2026. If you're reading this and Congress hasn't acted on a new extension, call your parent's provider to ask about contingency plans.
  • Permanent legislation — Several bills have been introduced to make Medicare telehealth expansion permanent, but none have passed as of this writing. The bipartisan "CONNECT for Health Act" is the most prominent.
  • State-level rules — Even if federal Medicare rules change, many states have their own telehealth parity laws requiring private insurers to cover telehealth. But these don't apply to Original Medicare (only to Medicaid and private plans regulated at the state level).

What You Should Do Right Now

Whether or not the rules change, getting your parent's telehealth infrastructure solid now means you're prepared either way.

1. Confirm coverage with their specific plan. Call the number on the back of their Medicare card (or log into Medicare.gov) and ask: "Is telehealth covered under this plan, and what's the copay?" Don't assume — verify.

2. Set up portal access now, not during a crisis. If your parent uses MyChart, Healow, or another patient portal, make sure they can log in and that you have proxy access to manage appointments on their behalf. The worst time to troubleshoot a login is ten minutes before the visit.

3. Keep records of telehealth visits. If coverage rules change, having documentation that your parent has been successfully using telehealth for ongoing care strengthens the case for continuity — and helps if you need to appeal a denied claim.

4. Check if their provider offers "hybrid" scheduling. Many practices now offer a mix of in-person and virtual visits. Establishing this pattern means your parent isn't fully dependent on telehealth even if rules tighten.

The Bigger Picture

Medicare telehealth isn't just about convenience — it's about access. For the parent who can't drive, who lives in a rural area, or who becomes anxious in medical waiting rooms, telehealth is the difference between getting care and going without it.

The policy landscape is still shifting, but the direction is clear: telehealth is becoming standard care, not an emergency measure. The question is whether the regulations can keep up with reality.

If you're managing your parent's healthcare remotely, the Telehealth Parent Guide covers everything from portal proxy access to device setup to troubleshooting the audio problems that derail every other visit. It's the $14 playbook that turns reactive crisis management into a system that works — regardless of what Congress decides next.