Quick Summary: Telemedicine has become a natural part of everyday healthcare, and most insurance plans now include virtual visits for routine care, mental health, and follow-ups. It isn’t meant to replace in-person appointments, but to give people more flexibility, faster access, and a convenient way to stay connected to their care team. As coverage continues to expand, it’s worth reviewing your plan to make sure it supports the way you receive care today.
In San Diego and across the country, the way we see our doctors and manage our health is changing fast. More people every day are choosing to meet with health care providers online.Â
Fact:Â Telehealth adoption surged after COVID-19 – Medicare telehealth usage increased 63-fold during 2020, according to the U.S. Department of Health & Human Services (HHS).
As of 2025, this survey from Harmony Healthcare IT indicates that about 77% of Americans think telehealth is the future of health care. Up to 62% use telehealth for medical needs, and 68% prefer the convenience of telehealth to in-person conversations.Â
As a result, this shift to telemedicine and virtual care is changing how insurance companies define care and what they cover.
Whether you are a senior, a parent, or a business owner trying to support your employees, understanding how telehealth fits into your coverage and day-to-day care has become incredibly relevant when it comes to planning for your health.
This is about more than technology. It affects how you get support, how quickly you access care, and how insurance plans keep up with your real needs. Knowing what telemedicine and virtual care mean helps you make better decisions, whether you manage your own care or look out for your family or employees.
What Telemedicine and Telehealth Mean
The terms telemedicine and telehealth are often used interchangeably, but they don’t mean exactly the same thing.
Quick Tip: The U.S. Office for Civil Rights requires all telehealth platforms to comply with HIPAA privacy rules, protecting patient data. More info: HIPAA FAQs for Professionals
Telehealth is the broader term. It refers to a wide range of health care services delivered remotely by health care professionals. This can include video visits with a primary care doctor or specialist, virtual mental health counseling, remote monitoring for chronic conditions, and even medical advice provided by phone or secure messaging.
Telemedicine is a more specific part of telehealth. It focuses on direct clinical care, such as diagnosing an illness, prescribing medication, or following up after an in-person visit, all without requiring you to go into a medical office.
In short, telehealth describes the full spectrum of virtual health services, while telemedicine refers specifically to virtual medical visits and treatment.
Telehealth Visits and Virtual Appointments
A telehealth visit allows you to see or talk to a doctor or nurse from home using your computer, tablet, or phone. These virtual appointments can handle routine checkups, medication reviews, or questions about ongoing symptoms.Â
Many local practices in San Diego now offer secure video platforms, so your visit is private and compliant with all national health privacy laws.
In-Person Visits and Patient Care
While telehealth expands access, there are times when in-person visits remain essential. Physical exams, lab work, vaccinations, and imaging all require a face-to-face encounter with a provider.Â
Telemedicine is not about replacing in-person care but offering flexible options for when an office visit is not practical.
Services Provided Remotely
Health care teams in San Diego increasingly deliver services such as chronic disease follow-up, therapy, nutrition counseling, and some urgent evaluations remotely. For many, especially those with mobility limitations or busy schedules, this option removes barriers and saves time.Â
Ultimately, the most important thing is that care remains comprehensive and centered on your needs.
Fact: The CDC reports that over 37% of adults used telemedicine in the past 12 months, with the highest use among older adults.
Growth of Virtual Care in Health Insurance
The surge in telemedicine usage has led health insurance providers to expand what they cover. This move brings more flexibility and choice for individuals, families, and especially Medicare beneficiaries.
Quick Benefit Table:
| Type of Plan | Typical Telehealth Coverage | Notes |
| Medicare Advantage | Often covers telehealth & mental health | May include $0 copays |
| Employer Plans | Virtual urgent + primary care | Often bundled with wellness programs |
| Individual ACA Plans | Widespread telehealth support | Compare networks & covered platforms |
| Medicaid | Expanded telehealth in most states | Coverage varies by state |
Medicare Advantage and Telehealth Coverage
Medicare Advantage plans, which more than half of seniors now choose, have added coverage for telehealth. This step came after the COVID-19 emergency accelerated adoption and made it clear that virtual care addresses real gaps in access.
Telehealth Appointments with Health Care Professionals
For families and younger adults, most employer health plans and individual policies now include virtual appointments as a standard benefit. Insurers recognize that timely advice or quick follow-up helps prevent minor issues from turning into something serious.
Most Telehealth Services Are Now Covered
Just a few years ago, telemedicine was a niche offering. Today, coverage for virtual care is widespread in San Diego. Insurers now cover not just medical concerns, but also virtual behavioral health, therapy, and some specialty consults.Â
The bottom line is that insurance is evolving to match what real people need every day.
Telemedicine Insurance Coverage for Seniors
For Medicare beneficiaries, telehealth access expanded significantly during and after COVID. However, some of the broadest Original Medicare flexibilities are scheduled to change in 2026.Â
Through January 30, 2026, Original Medicare (Part B) covers many telehealth services from anywhere in the U.S., including your home. Starting January 31, 2026, most telehealth services under Original Medicare return to earlier rules that generally require you to be in a rural area and located at a rural medical facility for the visit.Â
Even after the change, Medicare continues to cover certain telehealth services in more settings, including mental/behavioral health (including substance use disorder) services in your home, monthly ESRD visits for home dialysis, and acute stroke evaluation/treatment wherever you are (including mobile stroke units).
Medicare Advantage Plan Options
Medicare Advantage plans cover Medicare-covered services and may also offer additional telehealth/remote access benefits beyond what Original Medicare covers.Â
Because plan benefits and copays vary, it’s smart to review your Evidence of Coverage or plan summary to see what telehealth visits cost and which providers you can use.
Covered Office Visits and In-Network Providers
Confirm with your insurance or plan advisor which services and which doctors are available by telehealth, since coverage may be limited to in-network providers. In San Diego, networks like Sharp, Scripps, and UC San Diego Health offer broad telemedicine services for their Medicare members.
Comparing Virtual and In-Person Visits
Under Original Medicare, you’ll generally pay the same cost-sharing for telehealth as you would in person (after your Part B deductible, typically 20% of the Medicare-approved amount). Medicare Advantage copays may be similar, or different, depending on the plan.
Telemedicine Coverage for Businesses and Employees
Local employers and small business owners in San Diego have seen telehealth turn into a cornerstone of employee benefit plans. This shift addresses both productivity and the growing demand for accessible, real-time support.
Employee Access to Virtual Appointments
Many businesses now partner with health plans that provide employees with round-the-clock access to urgent care or primary care by video or phone. This not only keeps workers healthier but also helps reduce time away from the office or customer sites.
Telehealth Services as Part of Health Benefits
Telehealth is now a standard benefit in many group health plans, especially those that focus on cost control without sacrificing access. Employees can use virtual appointments for preventive care, chronic condition management, or routine sick visits.Â
Mental Health and Workplace Support
Workplace stress and mental health needs have grown, making virtual therapy or counseling a much-needed feature of employee benefit packages. Popular platforms like Teladoc and Amwell partner with local insurers, giving San Diego workers more paths to help without stigma or delay.Â
For businesses that want to support staff well-being, making sure virtual mental health visits are covered is one of the most important things to check during benefit selection.
Choosing Telehealth Coverage
Picking an insurance plan that matches your lifestyle, health needs, and budget is always a balance. Virtual care adds a new factor to consider, whether you are shopping for yourself, your family, or your employees.
Questions to Ask Health Care Professionals
During open enrollment or plan review, ask your insurance advisor or plan provider about these points:
- Are telehealth visits included for all levels of care or only certain specialists?
- What is the cost difference, if any, between virtual and in-person visits?
- Are mental health and chronic disease services covered by telemedicine?
It also pays to check local provider networks, since not all practices participate in virtual care, even if your insurance covers it.
Understanding Services Provided
Make sure you know which types of visits or therapies are available by video, phone, or chat. Some plans limit telehealth to urgent or primary care, while others offer a full suite of services, including nutrition, physical therapy, and dermatology.
Balancing Cost and Care
Look at copays, deductibles, and out-of-pocket limits for both traditional and virtual visits. Sometimes, the savings in travel and time alone justify favoring a plan with stronger telehealth support.Â
At the end of the day, the goal is to choose a plan that truly simplifies your access to care while protecting your budget.
Future Trends in Virtual Health Services
Virtual care represents an ongoing transformation in health services, which will shape how clients of all ages receive support in the years ahead.
Advancements in Virtual Care Technology
Emerging technologies like remote monitoring, app-based health coaching, and integration with wearable devices will continue to grow. More providers in San Diego are using secure apps to track blood pressure, blood sugar, and symptoms between visits.
Expanding Coverage for Most Telehealth Services
Insurers are expected to increase coverage for additional telehealth services, including more complex specialties and at-home diagnostic tools. This means easier access not just for busy adults, but for housebound seniors and families with children.
Integration with Traditional Health Care
The future points to a seamless mix of in-person and virtual care, with shared patient records and team-based approaches to health. Clients will be able to choose the right type of visit for each need, rather than face a rigid one-size-fits-all model.Â
For San Diegans, the mix of trusted local care and leading-edge technology is the most important thing to watch as you plan for your family’s or business’s needs.
Make Sure Your Coverage Keeps Up With How Care Is Delivered
Health care has changed, and telemedicine is now part of how people actually use their insurance. However, access only matters if your coverage supports it.
Whether you’re on Medicare, managing a busy household, or offering benefits to employees, telehealth coverage deserves a closer look. The details matter, and gaps in coverage are easy to miss until you need care.
At Terri Yurek Insurance, we help San Diego individuals, families, and business owners understand their options and choose plans that fit how health care works today. If you’re unsure how telemedicine fits into your current coverage, now is the time to ask.
Schedule a consultation with our trusted brokers today to review your plan and options.
Frequently Asked Questions (FAQs)
- What is the difference between telehealth and telemedicine?
- Telehealth includes all remote health services, while telemedicine refers specifically to virtual medical visits and treatment.
- Is telemedicine covered by insurance in California?
- Yes. Most health insurance plans in California, including Medicare Advantage and employer-sponsored plans, cover telehealth services in compliance with CMS and state regulations.
- Does Medicare still cover telehealth in 2025?
- Yes. CMS has permanently expanded telehealth coverage under Medicare Advantage, including mental health and chronic care services.
- Are telehealth visits cheaper than in-person visits?
- Often yes. Many plans charge the same or lower copays for telehealth, and patients save on travel and time costs.
- Can businesses legally offer telehealth as an employee benefit?
- Yes. The U.S. Department of Labor recognizes telehealth as a compliant and valuable health benefit when included in group health plans.
- What services are not suitable for telemedicine?
- Physical exams, imaging, surgeries, and procedures requiring hands-on care still require in-person visits.
- Are mental health visits covered virtually?
- Most insurance now supports virtual therapy and counseling, sometimes with the same copay as in-person visits.
