Telehealth Coverage in 2026: What Health Insurance Plans Must Cover

The Rise of Telehealth in American Health Insurance

Telehealth has transformed from a niche convenience into a fundamental component of health insurance coverage. What began as an emergency measure during the COVID-19 pandemic has become a permanent fixture of the American healthcare system. In 2026, more than 85% of private health insurance plans include some form of telehealth benefit, and virtual care visits now account for nearly one-quarter of all outpatient interactions nationwide.

For consumers, this shift means more options, greater convenience, and often lower costs. But navigating telehealth coverage can be confusing. State laws vary widely, not every service is covered equally, and cost-sharing rules for virtual visits differ from plan to plan. This guide breaks down everything you need to know about telehealth coverage in 2026, from state parity laws to choosing the right health insurance plan for your virtual care needs.

State Telehealth Parity Laws: What Your State Requires

Telehealth parity laws are state-level regulations that require private health insurers to cover telehealth services on the same terms, conditions, and reimbursement rates as equivalent in-person services. These laws are the primary driver of telehealth access in commercial insurance, and they vary significantly from state to state.

As of 2026, there are three broad categories of state telehealth parity legislation:

• Full parity states: These states require insurers to reimburse telehealth at the same rate as in-person visits and prohibit insurers from imposing additional restrictions on virtual care that do not apply to in-person care. States in this category include California, Colorado, Delaware, Georgia, Hawaii, Minnesota, Mississippi, New Jersey, New York, Oregon, Virginia, Washington, and others. Full parity means your insurer cannot charge you a higher copay for a telehealth visit than for an equivalent office visit.
• Coverage parity states: These states require insurers to cover telehealth services but do not mandate equal reimbursement rates. Insurers must pay for the same types of services delivered via telehealth as they would in person, but they may negotiate lower rates with telehealth providers. This means your coverage is protected, but the amount your provider receives may differ.
• Limited or no parity states: A small number of states have minimal or no telehealth parity requirements for private insurers. In these states, telehealth coverage depends entirely on what each insurance company chooses to include in its plan design. Even in these states, most major insurers voluntarily offer telehealth benefits because of consumer demand.

It is important to note that state parity laws apply to fully insured plans, which include most individual, small group, and ACA marketplace plans. Large self-insured employer plans are regulated under federal ERISA law and are generally not subject to state telehealth mandates, though most large employers have voluntarily adopted robust telehealth benefits.

What ACA Plans Must Cover via Telehealth

The Affordable Care Act requires all marketplace plans to cover ten categories of essential health benefits, but it does not explicitly mandate that those services be available via telehealth. However, the practical reality in 2026 is that virtually all ACA marketplace plans include telehealth access for a wide range of covered services. This is driven by a combination of state parity laws, competitive market pressure, and regulatory guidance from the Centers for Medicare and Medicaid Services.

Essential health benefit categories that are commonly delivered via telehealth in ACA plans include:

• Ambulatory patient services: Primary care consultations, follow-up visits, and specialist referrals conducted via video or phone.
• Mental health and substance use disorder services: Individual therapy, group therapy, psychiatric evaluations, and medication management. This is the single largest category of telehealth utilization.
• Preventive and wellness services: Health risk assessments, smoking cessation counseling, nutrition counseling, and chronic disease management education.
• Prescription drug management: Medication reviews, prescription refills, and dosage adjustments handled through virtual consultations.
• Rehabilitative services: Physical therapy evaluations, exercise guidance, and speech therapy sessions delivered via video.

When shopping for an ACA plan, compare telehealth benefits alongside other factors like network type, premium costs, and provider access. Not all marketplace plans offer the same breadth of telehealth services.

Common Telehealth Services Covered by Insurance

While telehealth cannot replace every type of medical care, the range of services available through virtual platforms has expanded dramatically. Here are the most common telehealth services covered by health insurance plans in 2026.

Urgent Care

Telehealth urgent care is the most frequently used virtual service. Patients can consult with a provider within minutes for conditions like cold and flu symptoms, sore throats, sinus infections, urinary tract infections, pink eye, mild allergic reactions, and minor skin irritations. Most plans cover telehealth urgent care 24 hours a day, seven days a week, with wait times averaging under 15 minutes. This makes telehealth an ideal alternative to crowded urgent care clinics and expensive emergency room visits for non-life-threatening conditions.

Mental Health and Behavioral Health

Mental health is the largest and fastest-growing category of telehealth utilization. Virtual therapy and psychiatry appointments are covered by the vast majority of health insurance plans, and federal mental health parity laws require that coverage be equivalent to coverage for medical and surgical services. Common mental health telehealth services include individual psychotherapy, cognitive behavioral therapy, psychiatric evaluations and medication management, group therapy sessions, substance use disorder counseling, and crisis intervention. Telehealth has been particularly transformative for mental health because it eliminates geographic barriers, reduces stigma associated with visiting a mental health clinic, and makes it significantly easier for patients to maintain consistent weekly or biweekly appointment schedules.

Dermatology

Teledermatology allows patients to receive consultations for skin conditions using high-resolution photos or live video. Common conditions treated include acne, eczema, psoriasis, rashes, suspicious moles, and fungal infections. Many plans cover asynchronous dermatology consultations, where you upload photos and a dermatologist reviews them within 24 to 48 hours, as well as synchronous live video appointments. Teledermatology is especially valuable in areas where in-person dermatologists have long wait times, which can stretch to several months in many parts of the country.

Chronic Disease Management

Telehealth has become an essential tool for managing chronic conditions like diabetes, hypertension, heart disease, asthma, and COPD. Remote patient monitoring programs allow providers to track vital signs, blood glucose levels, blood pressure readings, and other metrics in real time using connected devices. Patients receive regular virtual check-ins to review their data, adjust medications, and address any concerns without needing to travel to a clinic. Insurance coverage for remote patient monitoring has expanded significantly in 2026, with many plans covering both the virtual consultations and the connected monitoring devices as durable medical equipment.

Cost-Sharing for Telehealth vs. In-Person Visits

One of the biggest advantages of telehealth is the potential for lower out-of-pocket costs. However, cost-sharing structures vary significantly depending on your plan type, your state's parity laws, and the specific service being delivered.

Here is how telehealth cost-sharing typically compares to in-person visits across different plan types:

• Telehealth urgent care: $0 to $75 copay (many plans offer $0 telehealth urgent care). In-person urgent care typically costs $50 to $150 copay. Emergency room visits average $250 to $500 copay plus facility fees.
• Telehealth primary care: $0 to $50 copay, compared to $20 to $75 for an in-person primary care visit. Some telehealth-first plans offer unlimited $0 virtual primary care visits.
• Telehealth mental health: $0 to $60 copay for therapy sessions, compared to $25 to $75 for in-person therapy. Psychiatry visits via telehealth typically cost $40 to $100, compared to $50 to $150 in person.
• Telehealth specialist consultations: $25 to $100 copay, which is comparable to or slightly lower than in-person specialist copays of $40 to $100.

In states with full parity laws, insurers must charge the same cost-sharing for telehealth and in-person visits. In states without parity requirements, many insurers choose to offer lower copays for telehealth as an incentive to steer members toward less expensive virtual care. Be aware that some plans, particularly high-deductible health plans, may apply telehealth visits to your annual deductible rather than offering a flat copay, which means you could pay $150 to $250 per visit until your deductible is met.

HSA-Eligible Telehealth: What You Need to Know

Health Savings Accounts remain one of the most tax-advantaged tools for paying healthcare expenses, but they come with strict rules. To contribute to an HSA, you must be enrolled in a qualified high-deductible health plan. Under normal HDHP rules, the plan cannot cover any services before the deductible is met except for preventive care. This created a conflict with telehealth, because offering $0-copay virtual visits would technically disqualify the plan from HSA eligibility.

Congress addressed this issue by passing legislation that creates an exception allowing HDHPs to cover telehealth services before the deductible without jeopardizing HSA eligibility. This exception, originally introduced in the CARES Act of 2020 and extended multiple times since, remains in effect through at least the end of 2026. For the 2026 plan year, HDHP minimum deductibles are $1,650 for self-only coverage and $3,300 for family coverage, with out-of-pocket maximums of $8,300 and $16,600 respectively.

If you have an HSA-eligible HDHP, check whether your plan takes advantage of this exception. Many employer-sponsored HDHPs and marketplace-listed HDHPs now offer pre-deductible telehealth, meaning you can see a doctor virtually with a $0 or low copay and still make full HSA contributions. You can use HSA funds to pay for any telehealth copays, and if your telehealth visits are subject to the deductible, those payments count toward meeting it.

Employer Plan Telehealth Benefits

Employer-sponsored health plans have been at the forefront of telehealth adoption. According to industry surveys, more than 95% of large employers with 500 or more employees offered telehealth benefits in their health plans as of 2025, and that number has continued to grow. Employer plans often provide more generous telehealth benefits than individual market plans because employers view virtual care as a cost-saving tool that reduces absenteeism and improves employee satisfaction.

Common telehealth benefits in employer plans include:

• Embedded telehealth platforms: Many employers contract with telehealth vendors like Teladoc, MDLive, or Amwell and embed their services directly into the health plan. Employees access telehealth through their insurer's app or a dedicated platform.
• $0-copay virtual visits: A growing number of employers waive copays entirely for telehealth visits, particularly for urgent care and primary care. This incentivizes employees to use lower-cost virtual care instead of expensive in-person or ER visits.
• Employee Assistance Program telehealth: Many employers offer free short-term mental health counseling through EAPs, often delivered via telehealth, as a supplement to their health plan's mental health benefits.
• Virtual second opinions: Some employer plans cover telehealth consultations for second opinions on major diagnoses or surgery recommendations through partnerships with academic medical centers.
• Remote patient monitoring: Employers with wellness programs increasingly offer connected health devices and remote monitoring for employees managing chronic conditions like diabetes and hypertension.

Because large employer plans are self-insured and governed by federal ERISA law, they are not subject to state telehealth parity mandates. However, the competitive labor market has pushed most large employers to offer telehealth benefits that meet or exceed state parity standards. If you receive insurance through your employer, review your benefits guide or contact your HR department to understand exactly which telehealth services are available and what your cost-sharing will be.

Telehealth-First Health Insurance Plans

One of the most significant developments in health insurance over the past few years is the emergence of telehealth-first plans, also called virtual-first or virtual-primary plans. These are health insurance products built around virtual care as the default mode of accessing healthcare, with in-person care available when clinically necessary.

Telehealth-first plans typically share several common features:

• A dedicated virtual primary care provider who coordinates all of your care
• Unlimited $0-copay virtual visits for primary care, urgent care, and often behavioral health
• Lower monthly premiums compared to traditional plan designs, often 15% to 30% less
• A curated in-person network for when physical care is needed, accessed through referrals from your virtual provider
• Integrated digital tools like symptom checkers, health tracking dashboards, and secure messaging with your care team

Several major insurers now offer telehealth-first plans. Oscar Health has been a pioneer with its Virtual Primary Care plans available on ACA marketplaces in multiple states. Cigna's Evernorth Virtual-First plan pairs members with a virtual care team that handles most needs digitally. UnitedHealthcare's NavigateNOW plans assign members to a virtual-first provider group, and Humana and Anthem have introduced similar offerings. These plans are available on both the employer and individual markets, and some are offered on the ACA marketplace. When comparing telehealth-first plans to traditional plans, review the top-rated health insurance companies and their virtual care offerings side by side.

Popular Telehealth Platforms and How Insurance Works With Them

Several major telehealth platforms have become household names and are integrated with most health insurance plans. Understanding how each one works can help you get the most from your telehealth benefits.

Teladoc Health

Teladoc is the largest telehealth provider in the United States, serving more than 90 million members through partnerships with health plans, employers, and hospitals. Teladoc offers general medical visits, mental health therapy and psychiatry through its BetterHelp integration, dermatology, chronic disease management (including its Livongo programs for diabetes and hypertension), and specialist consultations. Most major health insurers, including UnitedHealthcare, Aetna, Blue Cross Blue Shield affiliates, and Cigna, include Teladoc as an in-network telehealth option. If your plan includes Teladoc, you typically pay your standard telehealth copay. Without insurance, Teladoc charges approximately $75 per general medical visit.

MDLive (Evernorth Health)

MDLive, now part of Cigna's Evernorth health services division, provides urgent care, primary care, dermatology, and behavioral health services via telehealth. MDLive is the primary telehealth platform for Cigna members and is also available through Humana, Health Alliance, and other insurers. MDLive offers both scheduled and on-demand video visits with board-certified physicians, licensed therapists, and psychiatrists. When accessed through an insurance plan, copays typically range from $0 to $75 depending on the service and your plan design. Without insurance, general medical visits cost approximately $82.

Amwell

Amwell partners with more than 55 health plans covering over 80 million members. The platform offers urgent care, therapy, psychiatry, nutrition counseling, lactation consulting, and chronic care management. Amwell is notable for its deep integration with health systems, allowing patients to see their own healthcare system's providers via the Amwell platform. This means continuity of care is maintained, with visit notes flowing directly into your existing medical record. Amwell is an in-network telehealth option for Anthem Blue Cross Blue Shield, several independent BCBS plans, and other regional insurers. Insurance copays vary by plan, and without insurance, visits cost approximately $79 to $99.

Other notable telehealth platforms that work with insurance include Doctor on Demand (now Included Health), Amazon Clinic, Sesame Care, and Wheel, as well as direct-to-consumer services like Cerebral for mental health and Hims/Hers for specific wellness needs. Always verify that your chosen platform is in your plan's network before scheduling a visit to avoid unexpected out-of-pocket costs.

How to Find a Telehealth-Friendly Health Insurance Plan

If telehealth is important to you, evaluating virtual care benefits should be a key part of your plan selection process. Here is a step-by-step approach to finding the most telehealth-friendly plan for your needs.

1. Check your state's parity laws. Start by understanding what your state requires. If you live in a full parity state, all fully insured plans must cover telehealth equivalently to in-person care. If not, telehealth benefits will vary more widely between plans.
2. Review the Summary of Benefits and Coverage. Look for a dedicated telehealth section that lists covered services, copay amounts, and any limitations. Pay attention to whether telehealth visits have a separate copay structure or are subject to the deductible.
3. Identify the telehealth platform. Determine which telehealth vendor the plan uses. Check whether it is a well-known platform like Teladoc, MDLive, or Amwell, and verify that the platform offers the specific services you need, such as mental health, dermatology, or chronic care management.
4. Compare telehealth copays. If you expect to use telehealth frequently, the difference between a $0 copay and a $50 copay per visit adds up quickly. Plans that offer unlimited $0-copay virtual visits can save you hundreds of dollars per year.
5. Ask about telehealth-first options. If you are comfortable receiving most of your care virtually, look specifically for telehealth-first or virtual-primary plans. These often have lower premiums and more generous virtual care benefits than traditional plans.
6. Evaluate mental health access. If you need therapy or psychiatric care, check how many in-network telehealth mental health providers are available, average wait times for scheduling, and whether the plan covers both therapy and medication management via video.
7. Confirm HSA compatibility. If you want to pair a high-deductible plan with an HSA, verify that the plan offers pre-deductible telehealth under the current legislative exception. Not all HDHPs have adopted this option.
8. Consider your in-person needs too. Even the most telehealth-friendly plan needs a solid in-person network for emergencies, procedures, and conditions that require hands-on care. Do not sacrifice in-person access solely for better telehealth benefits.

The Future of Telehealth Coverage

Telehealth coverage continues to evolve rapidly. Several trends are shaping the landscape for 2026 and beyond. Federal legislation to establish permanent nationwide telehealth standards is under discussion in Congress, which would create more uniformity across states. The integration of artificial intelligence into telehealth platforms is enabling better triage, more accurate symptom assessment, and faster routing to the right provider. Remote patient monitoring is expanding beyond chronic diseases into post-surgical recovery, prenatal care, and elder care. And new modalities like asynchronous video consultations, remote diagnostic tools, and hospital-at-home programs are blurring the lines between virtual and in-person care.

For consumers, the trajectory is clear: telehealth is becoming more accessible, more affordable, and more clinically capable every year. Health insurance plans that once treated virtual care as an optional add-on now build their products around it.

The Bottom Line

Telehealth has earned its place as a permanent, mainstream component of health insurance in 2026. More than 40 states now mandate some form of telehealth parity, most ACA marketplace plans include comprehensive virtual care benefits, and employer-sponsored plans overwhelmingly offer telehealth as a core benefit. Whether you need urgent care at midnight, weekly therapy sessions from your living room, or ongoing monitoring of a chronic condition, telehealth makes healthcare more accessible and often more affordable.

The most important steps you can take are to understand your state's telehealth laws, review your plan's specific telehealth benefits and cost-sharing structure, and choose a plan that aligns with how you prefer to receive care. If you value the convenience and cost savings of virtual visits, prioritize plans with low or zero telehealth copays, broad platform partnerships, and strong virtual mental health networks. And if you are choosing between plan types, remember that telehealth benefits should be one factor in a broader evaluation that includes premiums, deductibles, provider networks, prescription drug coverage, and total estimated annual costs.