Medicare Telehealth: What Hawai‘i Residents Need to Know About the 2025 Changes

Telehealth has been a lifeline for many kupuna and families across Hawai‘i, especially during and after the pandemic. It allows patients to see their doctors, mental health providers, or specialists without leaving home—something especially valuable in island communities where travel to appointments can be challenging.

But changes are on the horizon. Medicare’s telehealth coverage rules will shift beginning October 1, 2025, and it’s important to understand how these changes may affect you or your loved ones.

Telehealth Coverage Through September 30, 2025

Until the end of September 2025, Medicare beneficiaries can continue to access telehealth services:

• From any location in the U.S., including from home.
• For a wide range of health services such as routine check-ups, follow-ups, and specialist consultations.

This flexibility has helped many in Hawai‘i’s rural and urban areas alike by reducing the need for long trips, easing transportation burdens, and supporting timely care.

What Changes on October 1, 2025

Starting October 1, 2025, Medicare will tighten its rules:

• You must be physically located in a medical office or health facility in a rural area of the U.S. to receive most telehealth services.
• Home-based telehealth for general care will no longer be broadly available.

This means that for many in Hawai‘i—especially those living outside rural-designated areas—access to telehealth could look very different.

Exceptions: Services You Can Still Get From Home

Even after October 1, 2025, Medicare will continue to allow certain telehealth services wherever you are, including at home:

• Monthly End-Stage Renal Disease (ESRD) visits for home dialysis patients.
• Acute stroke services for diagnosis, evaluation, or treatment, including in mobile stroke units.
• Mental and behavioral health care, including treatment for substance use disorders, when delivered to patients in their homes.

These exceptions reflect critical areas where access to timely care can make a life-saving difference.

Why This Matters for Hawai‘i

In Hawai‘i, where interisland travel and transportation can be costly and time-consuming, telehealth has removed many barriers to care. Kupuna, those with mobility challenges, and families managing chronic conditions have especially benefited.

Understanding the upcoming changes allows our community to prepare:

• Talk with your doctors now about how your care plan may be affected.
• If you live in a rural-designated area, learn where qualifying facilities are located.
• If you rely on telehealth from home, find out whether your services fall under the exceptions.

How Hawai‘i SHIP Can Help

Hawai‘i SHIP provides free, confidential counseling to Medicare beneficiaries, their families, and caregivers. If you have questions about how telehealth changes may impact your care—or whether your services will still be covered—we’re here to guide you through the details.

📞 Reach out to Hawai‘i SHIP today to protect your access to care and stay informed.
🌺 Empower yourself with knowledge so you and your ʻohana can continue receiving the health services you need.