Sarah Borders, CEBS March 21, 2022 2 min read

Exemption Expanded for Telemedicine Services Under High Deductible Health Plans

A high deductible health plan (HDHP) partnered with an HSA usually can’t cover the costs of treatment until the participant reaches the HDHP’s statutory minimum deductible (except for preventive care). The CARES Act allowed an HDHP during plan years that begin on or before December 31, 2021, to also cover telehealth services with no cost sharing and not impact HSA eligibility.

On March 15, 2022, Congress passed the Consolidated Appropriations Act of 2022, which restores the exemption for telehealth services into 2022. This new legislation provides that telehealth and other remote care services will be considered disregarded coverage (will not cause a loss of HSA eligibility) during the months beginning after March 31, 2022, and before January 1, 2023. Also, during that nine-month period, plans may provide coverage for telehealth and other remote care services before the HDHP minimum deductible is satisfied without losing their HDHP status.

However, this extension only applies to telehealth services for the last nine months of 2022; specifically, telehealth services incurred after March 31, 2022, and before January 1, 2023. Both amendments apply to these months without regard to the HDHP’s plan year. This means the relief does not apply for the first three months of 2022, so some plans (e.g., calendar-year plans) must still apply their minimum deductible to telehealth and other remote care services during the first three months, but may waive them for the last nine months.

Impact to employers: If an employer’s carrier or TPA will implement telehealth with no cost sharing for the applicable months, the employer should communicate the coverage to participants, and will also want to make sure this benefit ends for their HDHP/HSA option at the end of 2022 (unless Congress extends the exemption). This relief does not require plans to waive telehealth or remote services, but if plans allow the relief, services incurred from April 1, 2022, to December 31, 2022, will not impact HDHP status or cause an individual to lose HSA-eligibility for those nine months.


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.