Effective January 1, 2025, the special COVID-era rule under the CARES Act that allowed employers sponsoring high-deductible health plans to provide free telehealth visits without affecting employees’ eligibility to contribute to health savings accounts (HSA) has expired. Employers must now either ensure that telehealth services are preventive or subject to the plan’s deductible, or they must charge for such services in order to maintain HSA eligibility for their employees.
As noted in our prior blog post on health plan coverage post-COVID-19 emergencies, for plan years beginning on or after January 1, 2020, through December 31, 2024, employers that sponsor high-deductible health plans could, but were not required to, offer free telehealth services before meeting the plan’s deductible without affecting participants’ eligibility to contribute to an HSA.
This rule allowing high-deductible health plan coverage for telehealth visits expired at the end of 2024, and efforts to include an extension in Congress’ year-end spending bill were not successful. Therefore, for plan years beginning after December 31, 2024, high-deductible health plans are not permitted to offer no-cost telehealth services (other than preventive services) before meeting the plan’s deductible without affecting participants’ eligibility to contribute to an HSA.
To date, legislative efforts to revive the rule have failed. Lawmakers in the Senate have introduced the bipartisan “Telehealth Expansion Act of 2025,” which aims to permanently allow high-deductible health plan participants to use their HSAs for telehealth services without first meeting their plan’s deductible; and there is a similar bill pending in the House of Representatives. As time passes, it is unclear whether either of these bills will become law.
The change to the telehealth rule took effect January 1, 2025, for calendar-year plans; for non-calendar-year plans, the sponsor will have until the end of the plan year that began in 2024 to implement the change. High-deductible health plan sponsors who still want to offer telehealth services for non-preventive services should determine how to charge for it while still preserving HSA eligibility for employees. Alternatively, plan sponsors could administer their high-deductible health plans to allow participants to engage in telehealth services only after meeting their annual deductible, thereby preserving their eligibility to contribute to an HSA.
If you need assistance evaluating your high-deductible health plan’s telehealth services, please contact the Faegre Drinker benefits team.
The material contained in this communication is informational, general in nature and does not constitute legal advice. The material contained in this communication should not be relied upon or used without consulting a lawyer to consider your specific circumstances. This communication was published on the date specified and may not include any changes in the topics, laws, rules or regulations covered. Receipt of this communication does not establish an attorney-client relationship. In some jurisdictions, this communication may be considered attorney advertising.
