This study evaluated factors associated with telehealth usage in the Department of Otolaryngology-Head and Neck Surgery at the Henry Ford Health System in Michigan. Between March 17 to May 1, 2020, virtual, telephone, and in-person visits as well as no-shows were analyzed. Those who were older, had Medicare insurance, and were in the two lowest quartiles of household income were less likely to complete a virtual visit compared to telephone or in-person visits before and after adjustment for age, sex, insurance type (including Medicaid, public insurance, and no insurance status), and household income. In univariate analyses comparing those who completed a virtual or telephone visit to those who were no-shows, those in the lowest two quartiles of median household income, Black patients, and patients with Medicaid, no insurance, or other public insurance had a lower likelihood of completing a virtual or telephone visit. Overall, these results indicate the importance of considering variables that impact patients’ participation in telehealth differs to improve access to appropriate healthcare.