2027 alertUnitedHealthcare, Wellcare, Humana and 5 other companies end some Medicare Advantage plans in Washington on December 31. (CMS data) 27 days left in Annual Enrollment (ends Dec. 7).Is your plan ending? →

Telehealth & Rural Medicare Access in Washington

Through December 31, 2027, Medicare covers telehealth visits from anywhere in the U.S., including your home, so people in Ferry, Pend Oreille, Garfield, Lincoln, Stevens, Okanogan and other rural Washington counties can see many doctors by video, and sometimes by phone, instead of driving hours. You pay the same as for an in-person visit: usually 20% of the Medicare-approved amount after the Part B deductible.

What Medicare telehealth covers in 2026 and 2027

Through December 31, 2027, Original Medicare covers telehealth services you get from anywhere in the U.S., including your home. Covered services include:

  • Office visits with doctors, nurse practitioners and physician assistants
  • Mental and behavioral health care, including psychotherapy and depression screening (audio-only allowed in many cases)
  • Consultations and follow-up visits, such as medication management
  • Other services on Medicare's telehealth list, which your provider can tell you about

Telehealth usually uses audio and video; audio-only is allowed in some cases. For most telehealth services, you pay the same as you would in person: after the Part B deductible ($283 in 2026), you usually pay 20% of the Medicare-approved amount.

Medicare Advantage plans must cover the telehealth services Original Medicare covers, and some offer more. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.

The home telehealth rules are temporary. The Consolidated Appropriations Act, 2026 extended them through December 31, 2027. Unless Congress extends them again, most telehealth after that will again require you to be at a clinic or other approved site in a rural area. Mental and behavioral health telehealth at home stays covered under permanent law, with an in-person visit requirement that starts January 1, 2028.

Audio-only and rural connectivity

Audio-only visits are an important option in rural Washington counties where broadband is patchy and many older residents rely on landlines or basic cell service. Through December 31, 2027, Medicare allows audio-only telehealth in some cases when you can't use video or don't want to and your provider has the technology. Mental and behavioral health visits by phone from home are part of permanent law. Ask your provider's office before the appointment which option it uses.

Critical Access Hospitals and Rural Health Clinics

Critical Access Hospitals (CAHs) are small rural hospitals with no more than 25 inpatient beds and 24-hour emergency care, generally more than 35 miles from another hospital (15 miles in mountainous terrain or areas with only secondary roads). Medicare pays them based on their costs. A 2023 Washington Legislature bill report counted 39 Critical Access Hospitals in Washington, many run by public hospital districts. Many CAHs and other rural providers also run Rural Health Clinics (RHCs), which provide primary care under Medicare.

Original Medicare covers care at any CAH or RHC that accepts Medicare. Medicare Advantage plans have their own networks, so check that your local hospital and clinic are in a plan's network before you enroll; networks can differ from plan to plan and can change each year.

Federally Qualified Health Centers (FQHCs) in Washington

FQHCs are community health centers that serve underserved areas and offer a sliding fee scale for people who qualify. Washington's centers include farmworker clinics, urban community health centers and tribal clinics. Medicare pays FQHCs a set rate per visit; you usually pay 20% coinsurance, and the Part B deductible doesn't apply to FQHC services.

Tribal health and IHS coordination

Members of federally recognized tribes can use tribal and Indian Health Service facilities directly. Medicare often works alongside tribal and IHS care; see our tribal health page.

Specialist access: a real challenge

Rural Washingtonians often drive long distances for specialty care, for example to Spokane or Wenatchee for cardiology, to Seattle or Spokane for cancer care, and to the large medical centers in the Puget Sound region or Spokane for neurology and complex surgery. Telehealth has reduced this travel but hasn't eliminated it. If you have a Medicare Advantage plan, confirm that the specialist you need is in network and offers virtual visits. If you live on an island, see health care and the San Juan Islands ferries.

Choosing a Medicare plan as a rural Washingtonian

Plan choices are thinner in some rural counties. For 2027, CMS lists 6 Medicare Advantage plans open to everyone in Ferry County and 6 in Garfield County, compared with 30 in King County. Some plans end in Washington at the end of 2026; see Washington plans ending in 2027.

  • Check that your local Critical Access Hospital, Rural Health Clinic and FQHC are in network on any Medicare Advantage plan you consider.
  • Check the plan's telehealth rules in its Evidence of Coverage, including whether out-of-network virtual visits are covered.
  • Check the Part D pharmacy network: look for a network pharmacy near you, and whether mail-order is available.
  • Original Medicare with a Medigap policy can make sense if your local hospital or specialists aren't in a Medicare Advantage network: Original Medicare has no network, so you can see any provider in the U.S. that accepts Medicare. See Original Medicare vs. Medicare Advantage in Washington.

To compare what's offered in your county, see plans in your ZIP code, or call (206) SENIORS (206-736-4677), TTY 711 to reach a licensed insurance agent with Benefits Life, at no cost to you, about plans from the companies they work with.

Sources

Frequently asked questions

Can I have a Medicare telehealth visit by phone?

In some cases. Through December 31, 2027, Medicare allows audio-only visits when you can't use video or don't want to and your provider can offer them. Mental and behavioral health visits by phone from home are part of permanent law. Ask your provider, and if you have a Medicare Advantage plan, check its rules.

Does Medicare cover telehealth from a provider in another state?

Medicare can cover it, but the provider generally has to be licensed to treat you where you are, which for Washington residents means licensed in Washington or practicing under an agreement Washington accepts. Medicare Advantage HMO plans may cover telehealth only from in-network providers.

If I live in a rural county, do I pay more for Medicare?

No. Part A and Part B premiums, deductibles and coinsurance are the same everywhere in Washington. What differs by county is which Medicare Advantage plans are offered and which doctors and hospitals are in their networks.

What is a Critical Access Hospital?

A small rural hospital certified by Medicare that has no more than 25 inpatient beds, offers 24-hour emergency care and is generally more than 35 miles from another hospital, or 15 miles in mountainous terrain or areas with only secondary roads. Medicare pays these hospitals based on their costs, which helps keep them open. Washington has 39 of them, according to a 2023 Washington Legislature bill report.

Licensed insurance agents for Washington

These independent insurance agents are licensed in Washington and work with Benefits Life, the publisher of this site. When they enroll you in a plan, the agent and Benefits Life may be paid by the insurance company. Learn more.

Austin Torres

Austin Torres

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Independent licensed insurance agent in Washington

Burien, WA · English

Mark Sims

Mark Sims

5.0 out of 5 stars (1 review on MedicareAgents.com)

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Independent licensed insurance agent in Washington

Kent, WA · English

Samia El-Moslimany

Samia El-Moslimany

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Independent licensed insurance agent in Washington

Burien, WA · English, Arabic

Katherine Torres

Katherine Torres

Accepting new clients

Independent licensed insurance agent in Washington

Seattle, WA · English

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