Key points
- Act 42 of 2024 requires state-regulated health insurance policies to cover medically necessary telemedicine services from in-network providers.
- A policy may not exclude a covered service only because it is delivered through telemedicine.
- The law does not require insurers to pay out-of-network providers for telemedicine.
- Self-insured employer plans are not regulated by the Pennsylvania Insurance Department.
- Mental health parity rules mean your plan cannot make mental health benefits more restrictive than medical benefits.
The short answer for Pennsylvania
Pennsylvania added a telemedicine chapter to its insurance law with Act 42 of 2024, signed on July 3, 2024. It says a health insurance policy offered, issued or renewed in Pennsylvania must cover medically necessary health care services provided through telemedicine by a participating network provider, consistent with the insurer's medical policies.
The law's definition of a health care service includes behavioral health, and its definition of telemedicine includes real-time audio or video sessions. A policy may not exclude a service from coverage solely because it is provided through telemedicine.
This article sums up what the official pages say, as general information as of October 2026. It is not legal advice, and your own plan documents are the final word on your benefits.
Which plans the law covers
Act 42 applies to health insurance policies from insurers licensed by the Pennsylvania Insurance Department. It lists policies it does not apply to, including accident only, long-term care or disability income, specified disease, Medicare supplement, TRICARE, fixed or hospital indemnity, workers' compensation and auto medical payment policies.
Timing depends on when a plan's forms or rates were filed. The Department of State's telemedicine FAQ explains that the rule applies to policies with forms or rates filed on or after March 31, 2025, which means some group plans issued or renewed in late 2025, and other group plans and all individual policies beginning in January 2026.
Many people get coverage through a self-insured employer plan, where the employer pays claims and a third party runs the plan. The Insurance Department says these plans are not regulated by the Department. If you are not sure which kind you have, it suggests asking your human resources or benefits office.
Medicaid and CHIP managed care plans have their own section of Act 42, which applies from January 1, 2026, with conditions. Locascio Wellness does not accept Medicaid.
What the law does not promise
Act 42 is a real protection, but it has limits worth knowing before your first session.
- In-network only: the law does not require an insurer to pay an out-of-network provider for telemedicine, though a plan may choose to
- Your plan's terms still apply: payment follows the contract between the insurer and the provider, so your copay or deductible depends on your plan
- Secure technology: the coverage rule does not apply if the telemedicine technology does not meet federal privacy and security rules such as HIPAA
- Same standard of care: a provider working by telemedicine is held to the same standard of care as in person
- No vendor lock-in: payment may not be conditioned on using one exclusive or proprietary telemedicine platform
Mental health parity in plain terms
Parity means fair treatment. The Insurance Department explains that the federal Mental Health Parity and Addiction Equity Act was adopted into Pennsylvania law in 2010. When a plan covers mental health care, it cannot make those benefits more restrictive than its medical and surgical benefits.
That covers what you pay (copays, coinsurance, deductibles and out-of-pocket maximums), visit limits, prior authorization rules, out-of-network coverage, and how the insurer decides what is medically necessary. Under the Affordable Care Act, the Department notes, individual and small group plans must offer mental health benefits.
If you believe your plan treats mental health care less favorably than medical care, the Department invites you to contact its Consumer Help Center or call 1-877-881-6388.
Questions to ask your insurer
- Is outpatient mental health therapy by video covered?Ask whether there are any differences from in-person visits, and whether a referral or prior authorization is needed.
- Is this therapist or practice in network?Give the practice name. Since Act 42 is tied to in-network care, this question matters most.
- What will I pay per session?Ask about your copay or coinsurance and how much of your deductible is left this year.
- Is my plan fully insured or self-insured?Your benefits office can tell you. It affects which rules apply and where to go with a complaint.
If you would rather not use insurance
Some people choose to pay for therapy themselves, for privacy, for flexibility, or because their plan does not cover the provider they want. Self-pay is a normal option and simply means you and your therapist do not need an insurer's approval to begin.
How we can help
Locascio Wellness offers therapy by secure video. Pennsylvania clients need to be physically located in Pennsylvania during each session, and we match you with a therapist licensed in Pennsylvania. Our online therapy in Pennsylvania page has more.
We are in-network with Aetna, Cigna, Highmark, Independence Blue Cross, Blue Cross Blue Shield plans, Geisinger, Optum, UnitedHealthcare and Medicare. Medicaid is not accepted, and self-pay is available. Coverage depends on your plan, so check our insurance and fees page, and our administrative team will verify your benefits before you start.
Therapists on our team work with people living with worry and stress through anxiety therapy, and with low mood through depression therapy. You can begin with a free 15-minute consultation on our booking page.
Therapy is for ongoing care, not emergencies. If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services. Sorting out coverage can feel like a chore, but it is usually one or two phone calls, and then you can focus on the part that matters.
Common questions
Does Pennsylvania law require insurance to cover video therapy?
For state-regulated health insurance policies, Act 42 of 2024 requires coverage of medically necessary services delivered by telemedicine from a participating in-network provider, consistent with the insurer's medical policies. A policy cannot exclude a covered service only because it is delivered by telemedicine. The rule phased in for policies with forms or rates filed on or after March 31, 2025. Check your own plan for details.
Does Act 42 apply to my employer's health plan?
It depends on the type of plan. Act 42 applies to policies from insurers licensed by the Pennsylvania Insurance Department. The Department says self-insured employer plans, where the employer pays claims itself, are not regulated by the Department. Your human resources or benefits office can tell you whether your plan is fully insured or self-insured.
Will my insurance pay for an out-of-network online therapist?
Act 42 does not require insurers to pay out-of-network providers for telemedicine, although a plan may choose to offer out-of-network benefits. Ask your insurer whether your plan has out-of-network coverage for outpatient mental health care and how reimbursement works. Choosing an in-network therapist is usually the simplest way to use your benefits.
Does Locascio Wellness take my insurance?
We are in-network with Aetna, Cigna, Highmark, Independence Blue Cross, Blue Cross Blue Shield plans, Geisinger, Optum, UnitedHealthcare and Medicare. Medicaid is not accepted. Coverage depends on your specific plan and the state, so our administrative team verifies benefits before your first session. Self-pay is also available.
Sources
Published by Locascio Wellness. Published October 23, 2026. Clinically reviewed by Anthony Locascio, PsyD, LPC. This page is general information, not medical advice or a diagnosis.