If you've been on Medicare for a while, you probably understand that your coverage changes from year to year. Some of those changes are good, like the $2,000 cap on out-of-pocket prescription drug costs that took effect this year. Others quietly remove or reduce benefits.
One benefit was scheduled to disappear at the start of 2025, but the government extended it for a few more months. However, it could still disappear later in the year. If you were counting upon this service to help you lower your costs, you may need to act fast.
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Medicare beneficiaries could find their telehealth access restricted in 2025
Telehealth became popular during the pandemic when people were wary about visiting doctors' offices in person. Medicare continued to cover telehealth services from anywhere through the end of 2024. It planned to restrict this benefit for those who didn't live in rural areas beginning in January 2025, but the federal government granted a three-month extension allowing the program to cover many telehealth appointments through the end of this month.
Because of this, you can currently receive telehealth services from eligible Medicare providers in your home with no geographic restrictions. If you have used this service in the last few years, you probably have an idea of what's covered and what isn't. If not, reach out to your healthcare provider or the Center for Medicare & Medicaid Services with any questions.
Fortunately, the government just further delayed restrictions on Medicare telehealth access for another six months. The House of Representatives passed a continuing resolution to fund the federal government through Sept. 30 that would extend telehealth access without geographic restrictions until this date. The Senate also approved the resolution, and President Trump signed the measure into law.
Telehealth access will continue for specific services
Even if no further extensions are granted beyond Sept. 30, telehealth access will still be covered after that date for behavioral and mental health treatments. There are no geographic restrictions for this type of care, so you can conduct these appointments from your home if you would like. This applies to both video and audio-only appointments.
However, after the extension ends, current law says you must schedule an in-person visit within six months of any initial Medicare behavioral telehealth appointment and have an annual in-person appointment thereafter. Those in rural areas served by Federally Qualified Health Centers (FQHCs) or Rural Health Clinics (RHCs) are exempt from this rule through Jan. 1, 2026.
You can check if your healthcare provider is a FQHC on the Health Resources and Services Administration website. You can also contact your state rural health association or your healthcare provider directly to find out if it qualifies for this exception.
Watch for future updates
Now that budget resolution has passed, telehealth services should continue as usual for most of 2025. However, it's tough to say what will happen beyond Sep. 30.
Should Medicare telehealth access become restricted later in the year, you may have to compare the costs of an in-person visit, including travel expenses, to the cost of paying for a telehealth visit out of pocket. Telehealth may be more affordable than in-person appointments, so it doesn't hurt to price out both options before deciding which is right for you.
