Five years ago, telemedicine was a novelty — a convenient alternative for minor issues when getting to a doctor’s office was genuinely inconvenient. Today, it’s a central component of how Americans access healthcare, and for small businesses offering health benefits, it’s become one of the most visible and valued features of any health plan.
According to the American Medical Association, telehealth use has increased more than 3,000% compared to pre-pandemic levels, with over 100 million Americans having used virtual care at least once. More importantly, the patients who’ve used it tend to keep using it: a 2023 McKinsey survey found that 40% of patients who tried telehealth for the first time during COVID-19 continued using it regularly afterward.
What Telemedicine Benefits Actually Cover
The term “telemedicine” covers a broader range of services than many small business owners realize. At minimum, most health plans with a telemedicine component offer on-demand urgent care visits — video or phone consultations for common, non-emergency conditions like sinus infections, UTIs, colds, rashes, and prescription refills. These visits are typically available 24/7 and can be completed in 15 to 20 minutes.
Beyond urgent care, many telemedicine platforms now offer scheduled appointments with primary care physicians, specialists, dermatologists, and mental health providers. Behavioral health via telehealth has been particularly transformative — for employees who struggle to find in-network therapists locally (a widespread problem), video-based therapy expands access dramatically.
Some advanced telemedicine programs also offer chronic disease management — remote monitoring of conditions like diabetes, hypertension, and heart disease through connected devices that transmit data to care teams. While less common in small group plans, these programs are growing and can dramatically reduce the cost and complexity of managing employees with high-cost conditions.
How Telemedicine Is Integrated Into Small Group Health Plans
Telemedicine isn’t always a standalone benefit — it’s often bundled into a health plan in ways that vary significantly between carriers. Understanding how telemedicine is structured in a given plan is essential for evaluating its real value.
Some plans include a dedicated telehealth platform — Teladoc, MDLive, Amwell, or a carrier-branded equivalent — that operates separately from the health plan’s cost-sharing structure. Employees can access these services for a flat copay (often $0 to $10 per visit) without it applying to their deductible. This is the most consumer-friendly structure because employees don’t have to meet their deductible before getting affordable virtual care.
Other plans run telemedicine visits through the standard health plan network, where they’re subject to the same deductible and cost-sharing as an in-office visit. For employees on high-deductible plans, this can make telehealth visits unexpectedly expensive until they’ve met their deductible — which undermines the convenience and affordability that make telemedicine attractive in the first place.
When shopping health plans, small business owners should specifically ask: How is telemedicine structured? What is the cost per visit for an employee who hasn’t met their deductible? What platform is used? These questions often reveal meaningful differences between plans that look similar on paper.
The Business Case for Telemedicine Benefits
Telemedicine benefits aren’t just an employee perk — they have a measurable impact on employer health plan costs and workforce productivity. When employees use virtual care for minor conditions instead of emergency rooms or urgent care centers, the cost difference is substantial. A telemedicine visit typically costs $40 to $75. An urgent care visit averages $150 to $300. An ER visit for a non-emergency condition averages $1,500 or more.
According to a 2022 study published in Health Affairs, employers that actively promoted telehealth utilization saw a 14% reduction in ER visits for conditions appropriate for virtual care. For a small business with a self-funded or level-funded plan, that reduction translates directly into lower claims costs and more favorable renewal rates.
Productivity is the other half of the business case. When an employee needs to see a doctor for a minor illness, traditional care requires scheduling an appointment, traveling to and from the office, and waiting — a process that can consume three to four hours of a workday. A telehealth visit can be completed on a lunch break or between meetings. For small businesses where each employee’s output matters, that time savings adds up across a team.
Mental Health Access Through Telemedicine
The mental health provider shortage in the United States is severe and well-documented. According to the Health Resources and Services Administration, more than 160 million Americans live in areas with a shortage of mental health professionals. Even for employees who don’t live in a designated shortage area, finding an in-network therapist who is accepting new patients and has availability can take weeks or months.
Telehealth has meaningfully expanded mental health access by eliminating geographic barriers. Employees can connect with licensed therapists, psychologists, and psychiatrists via video — often with shorter wait times than in-person care. Platforms like Talkspace, BetterHelp (for consumers), and Spring Health or Lyra Health (for employers) have built networks of thousands of licensed providers available for virtual sessions.
For small business employers, mental health parity laws require that behavioral health benefits be no more restrictive than medical benefits — but the practical challenge has always been access, not just coverage. Telemedicine doesn’t solve the shortage of providers, but it makes the available supply accessible to more employees, which is a meaningful improvement.
Pediatric and Family Telemedicine
Employees with children are among the heaviest users of telemedicine. Parents can connect with pediatricians for ear infections, rashes, fevers, and other common childhood conditions at 11pm — without driving to an urgent care center or waiting until the pediatrician’s office opens. This is a benefit that employees notice and appreciate, particularly working parents who juggle schedules tightly.
Family coverage under an employer-sponsored health plan often extends telemedicine benefits to covered dependents. Confirming this when reviewing plan options — and communicating it explicitly to employees during open enrollment — can significantly increase perceived benefits value without increasing plan cost.
Telemedicine Limitations Small Businesses Should Know
Telemedicine is not appropriate for all medical situations, and employees should understand its limitations to use it correctly. Conditions requiring physical examination, imaging, lab work, or hands-on treatment — orthopedic injuries, abdominal pain, chest pain, vision problems — are not appropriate for virtual care. Most reputable telemedicine platforms triage patients and will direct them to in-person care when appropriate.
Prescribing rules for telemedicine have also been in flux since the pandemic. The DEA’s expanded rules that allowed controlled substance prescriptions via telehealth during the public health emergency have been extended through 2025, but the long-term regulatory environment remains uncertain. For employees managing conditions that require controlled substances, this is worth monitoring.
Finally, not all employees will have reliable internet access or comfort with video technology. Telemedicine benefits should always include a phone-only option for employees who lack video capability or prefer it. Most platforms support this, but it’s worth confirming.
How to Communicate Telemedicine Benefits Effectively
One of the most consistent findings in benefits research is that employees underutilize benefits they don’t understand. A 2022 SHRM survey found that 40% of employees don’t fully understand their benefits package. Telemedicine is particularly prone to underutilization because employees may not know the platform name, how to download the app, or what conditions it covers.
Effective telemedicine communication includes: a dedicated section in the benefits guide with the platform name and download instructions, a brief demo during open enrollment (showing how to log in and start a visit), a reminder communication in January when employees are likely to get sick and may have forgotten about the benefit, and a one-pager employees can keep at home with the platform name and when to use it versus urgent care versus the ER.
Frequently Asked Questions
Is telemedicine covered the same way for out-of-state employees?
Generally yes, if the plan uses a national telemedicine platform like Teladoc or MDLive. These platforms are licensed in all 50 states and can provide care regardless of where the employee is located. However, prescriptions issued via telehealth must comply with the laws of the state where the patient is located, which varies. For employees who travel frequently or work in multiple states, this is worth understanding.
Can telemedicine visits count toward satisfying my deductible?
It depends on how the plan structures telemedicine. If visits go through the main health plan as in-network services, they may count toward the deductible. If telemedicine is a separate benefit with its own flat copay structure (common with platforms like Teladoc bundled into a plan), visits may not apply to the deductible. Check your Summary of Benefits and Coverage (SBC) or ask your broker.
What mental health conditions can be treated via telemedicine?
Most licensed therapists and psychiatrists practicing via telehealth can treat a wide range of conditions including anxiety, depression, ADHD, OCD, PTSD, and relationship issues. More severe conditions — acute psychosis, active suicidality requiring hospitalization, severe eating disorders — typically require in-person care. Telehealth mental health is appropriate for the vast majority of employees seeking mental health support.
Is telemedicine HIPAA-compliant?
Yes — reputable telemedicine platforms are HIPAA-compliant and use encrypted video and messaging technology. When evaluating telemedicine platforms, confirm HIPAA compliance and ask about their data privacy policies. Consumer-grade video tools like FaceTime or standard Zoom are not appropriate for clinical telemedicine visits.
Do employees need to already have a doctor to use telemedicine?
No. Most telemedicine platforms connect employees with available providers on demand — no existing patient relationship required. Some platforms also offer the ability to establish a relationship with a specific virtual primary care provider for continuity, but the on-demand model is the most common entry point and requires no prior relationship.
Get Expert Help Evaluating Telemedicine-Inclusive Health Plans
The difference between a health plan that includes robust telemedicine and one that buries it in fine print can mean thousands of dollars and hours of frustration for your employees. Evaluating these differences requires expertise in how carrier benefits are structured — which is exactly what an experienced benefits broker provides.
Garden State Benefits, led by broker Paul Z Olah, helps small businesses across New Jersey and beyond find health plans that deliver real value — including telemedicine benefits that employees will actually use. Paul compares plans across multiple carriers and helps you understand what you’re actually getting before you sign.
Call 856-880-6340 or email paul@gardenstatebenefits.com to schedule a consultation. At Garden State Benefits, you call and Paul answers.