Important Update Regarding Medicare Telehealth Coverage

As of October 1, 2025, changes to Original Medicare telehealth coverage are in effect due to Congress not extending pandemic-era telehealth policies. Now, Original Medicare will only cover most telehealth services for beneficiaries located in a rural office or medical facility.

Note: There are exceptions for monthly End-Stage Renal Disease (ESRD) visits; services for the diagnosis, evaluation, or treatment of symptoms of an acute stroke; or services for the diagnosis, evaluation, or treatment of a mental and/or behavioral health disorder, including a substance use disorder – these will continue to be covered under Original Medicare.

How This Affects Highmark Medicare Advantage and D-SNP Plans

While these changes impact Original Medicare, Highmark Medicare Advantage and D-SNP plans will continue to provide the same telehealth coverage offered throughout 2025. Furthermore, we plan to continue coverage of expanded telehealth benefits in 2026. For details on a specific plan's telehealth coverage, please refer to the Evidence of Coverage documents for a given benefit year.