Most Medicare Beneficiaries Will Lose This Popular Benefit on Jan. 31. Here's What Seniors Need to Know.

Source The Motley Fool

Key Points

  • In 2025, one quarter of all Medicare beneficiaries used telehealth services.

  • On Jan. 31, most seniors will be required to return to in-person visits for most services.

  • Congress has the power to extend the deadline or make the coverage permanent.

  • The $23,760 Social Security bonus most retirees completely overlook ›

Medicare telehealth has become remarkably popular since the pandemic. Roughly 10% of Medicare beneficiaries used telehealth services at the beginning of 2020. In 2025, that figure has grown to 25%, or nearly 6.8 million seniors. That's a remarkably popular service.

Yet, on Jan. 31, the pandemic-era flexibilities that enabled this growth are set to expire, and most Medicare beneficiaries will lose coverage for at-home telehealth appointments.

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What's changing on Jan. 31

Starting Jan. 31, Medicare telehealth coverage will return to what it was before the pandemic. Rural beneficiaries will still have access to some telehealth services but will no longer be able to access them from home. Instead, they will need to be physically present in a designated medical facility.

In contrast, urban and suburban seniors will lose all telehealth coverage for routine virtual appointments. Medication adjustments and standard follow-ups will require in-person visits.

Several provider types will also exit the telehealth program entirely, regardless of where the beneficiary lives. Physical therapists, occupational therapists, speech-language pathologists, and audiologists can no longer bill Medicare for telehealth services after Jan. 30

Person speaks with their doctor through their phone.

Image source: Getty Images.

Exceptions

Outpatient behavioral and mental health services are permanently protected for all seniors; beneficiaries can continue accessing therapy and psychiatric care from home. Beneficiaries are required to visit their mental health provider periodically. An in-person visit will be required every six months for new patients, while patients who have already been receiving care before the deadline will only need to visit once a year.

A few additional specific services also remain eligible for in-home telehealth access, like monthly visits for end-stage renal disease patients on home dialysis and acute stroke evaluations.

Will Congress act in time?

There is hope for seniors who have enjoyed the expanded access. Congress has repeatedly extended these flexibilities through temporary measures, and another is currently on the table that would extend coverage through the end of 2027. Unfortunately, as part of a broader spending bill, that extension is currently stalled and it's unclear whether Congress will be able to pass it in time.

Additional bills are pending that could extend or permanently establish broader telehealth coverage, but seniors should prepare themselves. There's no way to know if and when coverage will be extended. Consider your current telehealth use, and discuss alternatives with your doctor as soon as possible.

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