Medicare Telehealth Coverage Could Expire
Medicare has been covering certain telehealth services for the past five years, but the waivers for these services will expire on March 31 unless Congress takes action to extend them.
After the coronavirus outbreak in March 2020, Congress temporarily lifted some Medicare telehealth restrictions to allow patients to access healthcare remotely after medical providers closed their offices due to the COVID-19 pandemic. Telehealth allows patients and their healthcare providers to interact in real time online using a smartphone, computer, or tablet.
The current waiver has been extended several times under the previous Trump and Biden administrations. If Congress does not extend the waivers, the previous restrictions will be largely restored. This means that on April 1, Medicare will cover most telehealth appointments if they are conducted in person at rural medical facilities. Patients who are not in a rural setting could still have certain Medicare telehealth services covered, including monthly consultations about home dialysis for kidney failure, diagnosis and treatment of sudden stroke symptoms, and some mental health care.
Kaye Peterson of Lebanon, Kentucky, has been using telehealth services since the pandemic. Peterson, 67, told NBC News that she has type 1 diabetes and uses her iPhone for routine primary care. However, Peterson relies on her extended family to pick her up from the assisted living facility where she resides and drive nearly one hour to visit specialists.
“I’m in a care facility full of people in wheelchairs and on oxygen,” Peterson told NBC News. “It’s just a commonsense rule that needs to be extended.”
Dr. Saurabh Chandra, chief telehealth officer at the University of Mississippi Medical Center, said the current flexibility of telehealth rules can mean the difference between older adults having virtual appointments at 2 a.m. during busy flu seasons or traveling long distances to emergency rooms.
“This state was made for telehealth,” Dr. Chandra told NBC News.
Many Medicare beneficiaries have telehealth appointments scheduled months in advance, including patients of Dr. Cecil Bennett, a family medicine physician in Newnan, Georgia, just outside Atlanta. Dr. Bennett estimates that half of his clinic’s patients are on Medicare, and he frequently uses telehealth to give patients simple information, such as lab results. Dr. Bennett worries that without telehealth services, some patients may miss necessary in-person appointments, potentially leading to a worsening of their medical conditions.
“There’s no doubt in my mind that seniors are going to suffer if this waiver goes away,” Dr. Bennett told NBC News.
More Medicare Patients Use Telehealth Now Than Before the Pandemic
Data from health advocates and nonprofit organizations show just how much support telehealth receives from seniors. For instance, a January 2024 AARP poll found that nearly three-quarters of adults aged 50 and older used telehealth services at least once in the past 12 months. About half of those surveyed had Medicare, and nine in 10 said they were somewhat or very satisfied with their experience.
KFF, a nonpartisan nonprofit formerly known as the Kaiser Family Foundation, reports that telehealth is most popular among people 65 and older with long-term disabilities. According to KFF, which studies healthcare trends, telehealth is also popular among individuals who are eligible for both Medicare and Medicaid, a federal and state program that covers health and long-term care costs for those with limited income and assets.
Telehealth usage increased most during the COVID-19 pandemic, according to data from the Centers for Medicare and Medicaid Services (CMS). CMS data showed that fewer than 7 percent of Medicare patients used telehealth services during the first quarter of 2020, before the pandemic began. After the pandemic was declared, telehealth use among Medicare patients jumped to nearly 47 percent in the next quarter. By the end of 2023, the percentage had significantly decreased to about 13 percent, but that was still twice the rate of those using telehealth before the pandemic, according to Alex Cottrill, senior policy analyst for KFF’s Medicare policy program.
“Telehealth can be a lifeline for people with disabilities, especially for disabilities that impact their mobility,” Cottrill told AARP.
Although the virtual service uses fewer resources and requires less time for medical providers, Cottrill said it’s difficult to assess how much Medicare pays for the service. Medicare pays medical providers the same rates for telemedicine and in-person appointments.
Lawmakers Work on Telehealth Legislation As Deadline Looms
As Medicare patients continue to make their telehealth appointments, some Congress members are trying to ensure that Medicare will continue to cover the virtual meetings patients have with their healthcare providers.
Sen. Lisa Blunt Rochester, D-Del., co-introduced legislation during her time in Congress to permanently extend many Medicare telehealth flexibilities. In a statement to NBC News, Sen. Rochester said the flexibilities are “vital,” “especially for those in underserved and rural communities and those with accessibility or transportation barriers.” The senator told the outlet that she is still fighting for permanent protections.
Rep. Ro Khanna, D-Calif., said he plans to introduce similar legislation.
“What is the rationale for this other than making life more difficult for many seniors?” Khanna wrote in a post that went viral on the social media platform X.
With only a few weeks remaining until the deadline, there is still concern about potential consequences if the extension does not receive congressional approval.
“We are very worried about the potential for a telehealth cliff at the end of March where Medicare beneficiaries are suddenly unable to get care through telehealth,” said Andrew Scholnick, government affairs director at AARP.
Advocacy groups and medical professionals hope that Congress extends Medicare telehealth coverage that patients have benefited from since 2020.
“It’s probably the only good thing that came out of COVID, frankly, in terms of improving access because it’s been such a resounding success,” Nicholas Widmyer, director of federal affairs for the Bethesda, Maryland-based National Association of Community Health Centers, told AARP. “If it were to kind of lapse, that would be a step backwards for a lot of our patients’ ability to access primary care.”
Source Links:
https://www.nbcnews.com/news/us-news/senior-citizens-medicare-telehealth-coverage-expiring-rcna193487
https://www.aarp.org/health/medicare-insurance/info-2025/medicare-telehealth-coverage-deadline.html
