For many seniors, frequent doctor visits are a part of life, either to help them stay healthy or to manage chronic conditions that have developed over time. Having those visits covered by Medicare is important for seniors who don't want to pay out of their own pockets for the care they need.
Unfortunately, seniors will soon face new restrictions on coverage that could affect their ability to get the care they want. These restrictions will go into effect starting Jan. 31, 2026.
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Medicare has been covering this popular service for years
The new restrictions that Medicare is putting in place relate to a popular and convenient service a number of seniors have embraced: Telehealth services.
According to the Centers for Medicare and Medicaid Services, waivers went into effect starting March 6, 2020, that allowed Telehealth visits in a wide range of different situations and with a wide range of providers, including:
- Doctors
- Nurse practitioners
- Clinical psychologists
- Licensed clinical social workers
Telehealth visits could take place in many different environments under the waivers, including a retiree's place of residence, and still be covered by Medicare. That is changing now, though.
Medicare is putting strict new rules in place
While Telehealth makes it easier for retirees to get the care they need from the comfort of home, this will no longer be a Medicare option starting Jan. 31, 2026. According to an update from CMS: "Through January 30, 2026, beneficiaries can receive Medicare Telehealth services anywhere in the United States and territories. Starting January 31, 2026, except for behavioral health services, beneficiaries will generally need to be in a medical facility and in a rural area to receive Medicare Telehealth services."
This means you likely won't be able to get Telehealth visits covered unless:
- You're getting behavioral health services
- You live in a rural area
- You go to an office or medical facility for the Telehealth visit
However, there are exceptions for those who get:
- Monthly End-Stage Renal Disease (ESRD) visits for home dialysis
- Services for diagnosis, evaluation, or treatment of symptoms of an acute stroke in any location, including from a mobile stroke unit
- Services in their home that are aimed at diagnosing, treating, or evaluating a behavioral health disorder, such as a substance use disorder
Telehealth has become widespread, with the American Medical Association reporting that 71.4% of physicians said they used Telehealth in their practices at least weekly. Sadly, for most retirees, they'll now need to give up the convenience of talking to a doctor from home or pay for their Telehealth visits out of their retirement plans.
Alternatively, they may want to explore whether a Medicare Advantage plan may still be available with this coverage.
