Medicare's At-Home Care And Telehealth Restrictions In 2025 Could Limit Access To Affordable Healthcare – Here's What You Need To Know

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Access to telehealth and hospital-at-home care has been a lifeline for many older Americans. However, recent changes to Medicare coverage could disrupt these services in 2025, leaving beneficiaries uncertain about their options. Here's what you need to know about the potential restrictions and their impact.

During the COVID-19 pandemic, Medicare relaxed its rules to expand coverage of telehealth and hospital-at-home services. This allowed beneficiaries to receive virtual care when travel and in-person visits were a larger health risk. Congress and the Biden administration extended this coverage through December 2024, and a recent spending bill signed into law provides an additional three-month extension, ending the coverage in March 2025. 

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If the waivers are not extended again, Medicare will revert to its pre-pandemic restrictions, limiting telehealth services to primarily rural areas and requiring in-person visits before virtual appointments will be covered. 

Telehealth has become an essential tool for older adults and those with mobility challenges or who don't have convenient access to nearby health care providers. It allows patients to manage chronic conditions, attend follow-up appointments and receive mental health services without leaving their homes. 

Jackie Gehert, vice president of clinical informatics at Epic Research, told Chief Healthcare Executive that telehealth has been "able to give the care that otherwise may have otherwise been done in the exam room setting and actually give that care in a way that’s not only more convenient, but maybe even gets to a diagnosis or a plan of care faster than it might have taken if you had to wait for an in-person visit."

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Hospital-at-home programs provide acute care in a patient's home and have proved effective. These services often result in quicker recovery times and fewer readmissions than traditional hospital stays. According to Fortune, Medicare currently supports about 380 hospital systems that offer hospital-at-home programs. Without an extension of the waivers, many of these programs could end, disrupting patient care and halting new program development.

The cost of extending telehealth waivers has sparked debate in Congress. The Congressional Budget Office estimates that a two-year extension of telehealth services would cost Medicare approximately $4 billion. While hospital-at-home programs are budget-neutral, telehealth has become a target for cost-cutting measures, particularly under an administration focused on reducing Medicare spending.

If the waivers are not extended, older adults may face significant barriers to care. Telehealth services for mental health appointments will require in-person visits first and Medicare will no longer cover hospital-at-home services. Providers often schedule appointments months in advance and are already grappling with the uncertainty.

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Rachel Jenkins, senior associate director of federal relations at the American Hospital Association (AHA), told Fortune, "A three-month extension doesn't provide stability to the program, which is certainly key for our members."

Health care systems may hesitate to invest in new programs without a long-term commitment from Medicare.

While telehealth and hospital-at-home coverage advocates are optimistic about another extension, it's not certain whether President Donald Trump and Congress will decide to extend this Medicare coverage beyond March.

Medicare beneficiaries should stay informed and discuss alternative care options with their providers as March grows closer. 

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