Congress has failed to extend the High Deductible Health Plan (“HDHP”) exception for telehealth services.
Background. Under the Internal Revenue Code (“Code”), tax-exempt Health Savings Account (“HSA”) contributions may only be made by or for individuals who enroll in a HDHP, among other requirements. The Code and an IRS regulation provide the definition, required annual minimum deductible and out-of-pocket maximum for a HDHP. Payments from an HDHP prior to satisfying its annual minimum deductible are generally not permitted and can make an individual ineligible for HSA contributions.
The Coronavirus Aid, Relief, and Economic Security Act created an exception to the general rule under which an otherwise eligible individual with coverage under an HDHP may receive coverage for telehealth and other remote care services before satisfying the HDHP’s deductible and still maintain eligibility to contribute to an HSA. Pursuant to this exception, employers that sponsor HDHPs could elect, but were not required, to reimburse telehealth and other remote care services before an employee reaches the annual minimum deductible. Subsequent legislation extended this exception to cover plan years beginning in 2024.
The American Relief Act of 2025 initially included an extension of the telehealth service exception, but this extension was not included in the final version of the Act. Consequently, for calendar year plans the exception expired on December 31, 2024.
Action Steps for Employers that Sponsor HDHPs. Although employers currently should amend their HDHPs, and provide information to their employees, to reflect this change, there remains a possibility that Congress will retroactively reinstate the telehealth exception. Employers that sponsor HDHPs that included this exception are advised to work closely with qualified benefits advisers to ensure their continued legal compliance.