While telehealth expanded under Medicare during the COVID-19 pandemic, Medicare recipients will no longer be able to use telehealth services in many cases when coverage ends on January 30.
Why It Matters
Many retirees on Medicare rely on telehealth services for various treatments and doctor visits. This is especially helpful for those who live in rural areas or are treating specific types of ailments.
What To Know
After January 30, there will be strict new limits on who qualifies for telehealth coverage.
The exception is for behavioral health services. Otherwise, beneficiaries must be in a medical facility or a rural area for their telehealth to be covered under Medicare.
There are some key caveats, such as for those people with 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 should still be covered.
Coverage is also included for diagnosing, treating, or evaluating a behavioral health disorder, including substance use disorders.
According to the American Medical Association, 71.4 percent of doctors use telehealth options at least weekly.
“Telehealth is not shutting down but going back to pre-pandemic structure by reducing the level of servicing,” Kevin Thompson, the CEO of 9i Capital Group and the host of the 9innings podcast, told Newsweek. “Rural requirements and exceptions still apply for behavior and stroke victims, but the broad reach of telehealth will be closing.”
What People Are Saying
Alex Beene, a financial literacy instructor for the University of Tennessee at Martin, told Newsweek: “The end of telehealth coverage for Medicare beneficiaries at the end of this month will undoubtedly cause difficulties for some seniors who rely on it. However, it’s important to note that telehealth services will continue to be covered for the groups most dependent on it, including those who receive behavioral health services and those who live in rural areas.”
9i Capital Group CEO Kevin Thompson told Newsweek: “This all comes down to uncertainty, with doctors now trying to figure out future reimbursements for who can and cannot bill for telehealth services. Beneficiaries will now be forced to go back into the office and travel for basic things that could have been done over a telehealth call.”
What Happens Next
For those who don’t fit into the exceptions boxes, the lapse in telehealth coverage could make health care more difficult and expensive. Some Medicare Advantage plans might offer different options, but the impacts could still be felt on a wide scale, experts say.
“Those groups of recipients tend to have the most difficulty in regularly going to a medical facility for services,” Beene said. “At the same point, the reduction in those who can qualify for telehealth services is going to cause complications for the Medicare beneficiaries who don’t fall into one of those categories.”
