HOPE and Mental Wellbeing Act of 2025

This legislation aims to significantly enhance access to primary healthcare services for beneficiaries of federal health programs. It mandates that both Medicare and Medicaid cover the first three primary care visits each year without any cost sharing, beginning in 2026. Specifically, for Medicare beneficiaries, this means traditional Medicare and Medicare Advantage plans will be required to pay 100 percent of the approved amount for these initial visits, waiving deductibles and copayments. Similarly, Medicaid programs will be prohibited from imposing cost sharing for these first three primary care visits annually. A "primary care visit" is broadly defined to include essential services such as outpatient mental and behavioral health services , nonspecialty medical services, and care coordination. These services are intended for the prevention, diagnosis, treatment, or management of a wide array of physical, mental, or behavioral health conditions, thereby promoting earlier intervention and better overall health outcomes.