Telehealth Faces Uncertainty in Some Countries While Others Make It Permanent

Telehealth usage stopped being a pandemic story years ago. What has not settled down is the rulebook underneath it, and 2025 and 2026 made that gap more visible than ever: the same two years that saw a public telehealth platform in India cross half a billion consultations also saw the United States extend its core telehealth rules through a fourth and fifth round of short-term patches. This piece sets the market-sizing numbers in our companion report aside and focuses on what is actually moving in regulation, consolidation, and public-sector delivery across the past two years.

America's Telehealth Rules Keep Expiring on Purpose, Then Getting Extended Anyway

Two separate sets of US telehealth flexibilities have now been extended so many times that tracking the next deadline has become its own small industry. Medicare's telehealth coverage rules, including the removal of geographic restrictions and the waiver of in-person requirements for behavioral health, got their most recent lifeline in February 2026, when the Consolidated Appropriations Act, 2026 pushed the deadline out to December 31, 2027, the longest extension Congress has granted since the pandemic-era rules began expiring on a rolling basis. The DEA's separate flexibility, which lets clinicians prescribe Schedule II-V controlled substances through telemedicine without an initial in-person exam, has had a rougher path: its fourth temporary extension, issued in January 2026, only pushed the deadline to December 31, 2026, a single year rather than two.

The practical effect is that telehealth companies built around prescribing controlled medications, including treatments for ADHD and opioid use disorder, are still planning around a deadline that resets every twelve months rather than a settled rule. Congress has shown no sign of letting either flexibility lapse outright, but it has also shown no sign of making either one permanent, which leaves a meaningful slice of the US telehealth market operating under rules that are renewed just often enough to avoid a shutdown and rarely far enough ahead to plan around with confidence.

South Korea Chose the Opposite Approach

While the US kept patching its telehealth rules, South Korea's National Assembly passed an amendment to the Medical Service Act in December 2025 that gives remote care a permanent legal basis for the first time, set to take effect in December 2026 after a one-year grace period. The law arrives only after an estimated 15 million telemedicine visits had already taken place under temporary pandemic-era rules, so in one sense it is catching up to behavior that was already widespread rather than creating a new market from scratch.

What stands out is how cautious the permanent version is. Telemedicine-only clinics remain banned, neighborhood primary care clinics get priority over large hospitals, returning patients are favored over first-time remote visits, and narcotics and psychotropic drugs cannot be prescribed remotely at all. South Korea effectively chose to legalize telemedicine permanently while simultaneously narrowing what it can be used for, a different tradeoff than the US approach of broad temporary access renewed indefinitely.

Source: Holland & Knight (Jan 2026); Seoulz (Dec 2025); Chambers Digital Healthcare 2026, China chapter.

Half a Billion Consultations, Mostly Outside the Private Market

The single largest telehealth program in the world by volume is not run by a venture-backed company. India's government-operated eSanjeevani platform crossed 50 crore, or 500 million, cumulative teleconsultations in September 2026, run through a hub-and-spoke network that connects more than 1.42 lakh primary health spokes to specialist hubs across every state and union territory. The platform has recently extended into specialist outpatient teleconsultation at some of the country's top government hospitals, a step toward giving rural patients access to specialists they would otherwise have to travel far to see.

The scale is a reminder that telehealth's growth story looks different depending on where you measure it. In the US, growth is mostly a story of private platforms competing for payer contracts and consumer subscriptions under rules that keep almost expiring. In India, growth has been driven by a public program built specifically to reach areas private platforms have less commercial incentive to serve, and its scale now dwarfs any single private telehealth company's consultation volume.

Consolidation Is About Capabilities Now, Not Just Consultation Volume

Teladoc Health's two most notable deals in the past two years were not about buying more consultation volume. Its February 2025 acquisition of Catapult Health, a virtual preventive care company, added at-home diagnostic testing kits and lab-confirmed results that Teladoc plans to feed into its existing chronic condition programs. Its August 2025 acquisition of Telecare added a network of more than 300 virtual specialists in Australia, aimed at shortening specialist wait times in regional and remote areas rather than adding general consultation capacity.

Both deals point to the same underlying shift. After years of telehealth companies competing mainly on how many consultations they could handle, the more defensible move now looks like adding a capability a platform did not already have, whether that is diagnostic testing, specialist access, or a presence in a new country, rather than simply scaling the same consultation model further.

Related Vectomat Insights Coverage

This article provides editorial and R&D context only. For full market sizing, segmentation, regional share, competitive benchmarking and forecasts through 2035, see the companion Telehealth Services Market Report.