Sarah Borders, CEBS January 8, 2025 2 min read

Congress Has Not Yet Passed Telehealth Relief for HSAs

The bipartisan deal originally struck to prevent a government shutdown included a two-year extension allowing telehealth benefits at low- or no-cost before the deductible in an HSA-qualified plan. However, that deal ultimately did not pass, and what Congress settled on did not include an extension of telehealth relief for HSAs.

 

Applies To:

  • Employers of all sizes with an HSA-qualified HDHP coupled with a telehealth benefit.

 

 

Go Deeper:

As a reminder, high deductible health plans (HDHPs) qualified to couple with a health savings account (HSA) can only allow payment for preventive care expenses before the federal minimum deductible is met.  Otherwise, to be an HSA-qualified HDHP (or QHDHP), all non-preventive care must be subject to the deductible until the individual or family meets the federal minimum deductible.  For telehealth, this means charging a fair market value (FMV) the remote care provider is willing to accept as payment in full for the care provided.

Since COVID, relief allowed QHDHPs to charge low- or no-cost sharing for telehealth without applying the deductible.  However, unless Congress grants yet another extension, it looks like that relief is coming to a close.

 

Practical Impact to Employers:

Plan years beginning on or after January 1, 2025, need to plan on charging a FMV for non-preventive telehealth visits until the individual has met the federal minimum deductible required of QHDHPs.

If Congress eventually passes another extension, the employer should be ready to flip a switch allowing low- or no-cost sharing telehealth visits, possibly back to January 1, 2025.

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Sarah Borders, CEBS

Principal, Benefits Compliance Solutions. Sarah has spent the last 15 years in the employee benefits industry, has numerous designations and serves on NAHU’s Employer Working Group Subcommittee and is an active board member of Austin AHU. She recently stepped down as Vice President of Benefits Compliance at one of the nation's largest brokerage firms to start her own compliance consulting practice. Her designations include an active license with the Texas Department of Insurance, CEBS (Certified Employee Benefits Specialist), Certified Health Care Reform Professional, HIPAA certification and Health Care Service Associate. She holds an MBA from Texas A&M Corpus Christi and a BA from University of Incarnate Word. Her consulting firm, Benefits Compliance Solutions, partners with employers to identify unknown risks and avoid hundreds of thousands of dollars in fines and lawsuits from failure to comply with their healthplan obligations.

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