Telemedicine has become a routine part of healthcare, but it’s still common for patients to
wonder when a virtual visit is appropriate — and when an in-person visit is necessary.

At Aristos Internal Medicine, the goal is not to favor one format over the other, but to use the
right type of visit for the right situation, guided by clinical judgment, safety, regulations, and
patient needs.

How Insurance Treats Virtual Care

For many patients, insurance coverage is not a barrier to virtual care.

In Washington State, a telehealth parity law requires most commercial insurance plans to cover
virtual visits in the same way they cover in-person visits. This means copays and deductibles
are typically the same as an office visit.

Medicare currently covers virtual care through January 30, 2026. Coverage rules can evolve
over time, but telemedicine remains a widely supported option for Medicare beneficiaries.

Patients are always encouraged to verify their specific benefits, but for most people, virtual care
is treated similarly to in-person care by their insurance plan.

What Virtual Care Does Well

Virtual visits offer several meaningful advantages:

• Less time away from work or family
• No travel or waiting rooms
• Faster access to care when appropriate

Many aspects of adult primary care work very well through telemedicine, including:

• Follow-up visits
• Medication management
• Chronic disease care
• Preventive care discussions
• Many acute concerns

When used thoughtfully, virtual care can be both efficient and high-quality.

When an In-Person Visit Is Necessary

Despite its advantages, telemedicine cannot replace every aspect of medical care.

The most common reasons an in-person visit is needed include:

• The need for accurate vital signs, such as blood pressure or oxygen levels
• A physical examination that cannot be reliably performed remotely
• Diagnostic testing, procedures, or hands-on evaluation

In-person visits are recommended whenever they are necessary to ensure safe and appropriate
care.

How Technology Often Keeps Care Virtual

Advances in technology have expanded what can safely be done virtually.

Many patients now have access to home blood pressure cuffs and pulse oximeters. When
reliable home measurements are available, in-person visits can often be avoided.

In addition, many components of a physical exam — such as visual inspection, movement
assessment, and guided self-examination — can be performed effectively through video.

Virtual exams are used thoughtfully, with patient safety always guiding decisions.

Regulatory Requirements and Controlled Medications

In some cases, regulations require an in-person visit, regardless of how straightforward a
concern may seem.

This is particularly relevant for certain controlled medications, where federal or state rules
mandate in-person evaluation before prescribing. These requirements are regulatory, not
discretionary, and exist to promote patient safety and responsible prescribing.

When an in-person visit is required for regulatory reasons, this is explained clearly so patients
understand why it is necessary.

How the Decision Is Made

The choice between virtual and in-person care is based on:

• Clinical judgment
• Patient safety
• Regulatory requirements
• Patient preference, when appropriate

Visits may begin virtually and transition to in-person care if needed. Follow-up care is often well
suited to virtual visits.

Avoiding the “Either / Or” Trap

Virtual care and in-person care are not competitors — they are complementary.

High-quality primary care uses both thoughtfully. The goal is not to replace office visits, but to
use them more intentionally, reserving in-person care for situations where it adds clear value.

What Patients Can Expect

Patients can expect:

• Clear guidance when scheduling
• Honest recommendations during visits
• Transparency about insurance coverage and regulations
• No pressure to choose a visit format that isn’t appropriate

A Practical, Patient-Centered Model

Modern primary care should be adaptable, evidence-based, and centered on patient needs.
Used together, virtual and in-person care improve access, continuity, and quality.

If you’re looking for adult primary care that uses both approaches thoughtfully, appointments can
be scheduled online.

— Dr. Kyle Varner