On July 4, 2025, President Trump signed the One Big Beautiful Bill permanently allowing high-deductible health plans (HDHPs) to cover telehealth services before deductibles are met, without affecting health savings accounts (HSAs) eligibility. This applies to plan years starting after December 31, 2024.
Background
To contribute to an HSA, individuals must be covered by an HDHP that does not provide non-preventive benefits before meeting the annual deductible. Previously, those with free or reduced-cost telehealth coverage were not eligible for HSA contributions.
Congress responded to the COVID-19 pandemic by temporarily allowing HDHPs to cover telehealth services before deductibles were met. This relief, effective from 2020, was extended multiple times and now applies to plan years beginning after December 31, 2022, and before January 1, 2025.
The first-dollar telehealth exception expired at the end of 2024, but new legislation makes this relief permanent for plan years beginning on or after January 1, 2025.
Impact of Extension
With this permanent extension, HDHPs may waive deductibles for telehealth or remote care services for plan years beginning in 2025 and beyond, without affecting HSA eligibility. This is optional; telehealth services, except preventive care, can still be applied to the deductible.
Employers with HDHPs should review their telehealth coverage and communicate any updates to participants through an updated Summary Plan Description or Summary of Material Modifications. Download the bulletin for more details.
