Due to the shutdown of the federal government, funding has ended for the temporary telehealth flexibilities introduced during the COVID-19 pandemic. Until funding is restored, previous restrictions now apply. CalPERS is sharing this update to help members understand what has changed, why, and what it means for their health care.
Understanding the Changes in Medicare Telehealth Coverage
During the COVID-19 pandemic, Medicare temporarily expanded telehealth coverage to make it easier for people to connect with their doctors from home. These waivers allowed more providers to offer telehealth and made it possible for patients to use it for many routine visits. Since the pandemic, these waivers have been extended multiple times through various federal legislative actions.
As of September 30, 2025, those temporary rules have ended. Medicare still covers some telehealth services, but the range of services is now narrower than what was available during the pandemic.
For CalPERS members enrolled in Medicare Supplement plans, this change reduced the types of telehealth services that are covered. For members who are enrolled in Medicare Advantage plans, their telehealth coverage remains the same.
What Will Stay Covered
Even after September 30, Medicare will still cover telehealth services for:
- Mental and behavioral health care
- Substance use disorder treatment
- End-stage renal disease (ESRD) assessments
- Emergency stroke care
These services will continue to be available from home under Medicare rules.
What Will Change
Medicare Supplement members will no longer have coverage for many of the telehealth services that became available during the pandemic, including:
- Routine primary care visits
- Chronic condition management (such as diabetes, heart disease, or arthritis)
- Specialist consultations done virtually
- Most other follow-up visits that can currently be handled by telehealth
For Medicare Supplement members that use Teladoc, these services remain available and separately covered by your health plan.
This change is a result of the federal government shutdown and applies nationwide. It is unclear when the shutdown may end and what may occur with telehealth allowances afterward.
Medicare Advantage vs. Medicare Supplement: What’s the Difference?
This change affects Medicare members differently depending on the type of Medicare plan they have:
- Medicare Advantage: These are private insurance plans that contract with Medicare. They often include extra benefits, such as dental, vision, or broader telehealth coverage. Medicare Advantage plans will continue to offer expanded telehealth benefits even after September 30, 2025.
- Medicare Supplement Plans: These plans, including the PERS Gold and PERS Platinum Supplement plans, work alongside Original Medicare. They help cover costs such as deductibles and coinsurance but generally follow Medicare’s rules for what is covered. Because the telehealth waivers are ending for Original Medicare, Supplement plan members will lose coverage for many telehealth services, with the exception of Teladoc.
Why This Is Happening
It’s important to understand that this change is the result of the federal government shutdown and Medicare rules. Congress created temporary, telehealth flexibilities during the pandemic, but those flexibilities expired on September 30, 2025. Due to the shutdown, Congress was unable to take action to avoid the expiration of these services.
While Congress could choose to extend or reinstate telehealth waivers in the future, congressional action and funding of these services remains uncertain.
CalPERS’ Role
Part of our role is to make sure you are aware of important changes in Medicare that may affect your benefits. While we do not control Medicare coverage rules, we want our members to have current, reliable information.
We remain committed to supporting members by sharing updates about major Medicare policy changes and ensuring our call center and health plan partners are ready to answer your questions.