Telehealth use in traditional Medicare increased dramatically at the start of the COVID-19 public health emergency, with nearly half (46.7%) of all eligible beneficiaries receiving at least one telehealth service in the second quarter of 2020, compared to just 6.9% in the first quarter (Figure 2). While use has declined since that time, it remains nearly two times higher than pre-pandemic levels, with more than one in ten (12.5%) eligible beneficiaries receiving a telehealth service in the second quarter of 2025 (the most recent period for which data is available).
Use of telehealth services varies by geography, race and ethnicity, reason for Medicare eligibility, and dual enrollment in Medicare and Medicaid (Figure 3).
Reason for Medicare eligibility: Rates of telehealth use in 2024 were higher among beneficiaries who qualify for Medicare based on having end-stage renal disease (ESRD) (37%) or a long-term disability (36%), relative to those who qualify based on age (23%). This may be due in part to higher overall rates of service use among people with ESRD and disabilities (whether in-person or via telehealth) but may also reflect a preference for telehealth among these populations, or a greater ease of accessing care via telehealth relative to in-person care. Beneficiaries under age 65 who qualify for Medicare based on having long-term disabilities are more likely than older beneficiaries to report having three or more limitations in activities of daily living, and may be more likely to benefit from the increased flexibility of receiving health care services from their home via telehealth.
Dual-eligible individuals: Rates of telehealth use in 2024 were higher among beneficiaries dually eligible for both Medicare and Medicaid compared to Medicare beneficiaries who were not Medicaid eligible (35% vs. 23%). Dual-eligible individuals are four times more likely than other Medicare beneficiaries to live on incomes of less than $20,000. Prior studies have found that having lower income or living in a socioeconomically deprived neighborhood is associated with higher rates of telehealth use, suggesting that telehealth may have the potential to improve health care access for beneficiaries with limited access to in-person services.
Geography: Rates of telehealth use in 2024 were higher among beneficiaries living in urban areas than those in rural areas (26% vs. 19%), which may be due in part to disparities in access to broadband and other communication technologies. Beneficiaries in rural or underserved areas may lack the infrastructure to support reliable video telehealth visits or the means to afford internet access, which may further impede access to telehealth if coverage of audio-only services is reduced or eliminated.
Race and ethnicity: Rates of telehealth use in 2024 were highest among Asian and Pacific Islander (30%) and Hispanic (29%) beneficiaries, and somewhat lower among Black (26%), American Indian or Alaska Native (24%), and non-Hispanic White beneficiaries (24%). Given that beneficiaries of color are more likely than non-Hispanic White beneficiaries to report difficulty accessing needed health services, telehealth use may help to improve access to care for certain groups.
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