Reimbursement of Spouses' Medicare Premiums Under HRAs
Employees often inquire whether their spouse’s Medicare premiums are eligible for reimbursement under their Health Reimbursement Arrangement (HRA) and how to navigate the submission process. This guide addresses eligibility, documentation requirements, submission procedures, and key considerations.
Eligibility Criteria for Reimbursement
Yes, a spouse’s Medicare premiums are generally eligible for reimbursement under HRAs if specific conditions are met. The eligibility depends on the type of HRA offered by the employer:
ICHRAs: A spouse who is Medicare-eligible qualifies for Medicare premium reimbursement under an Individual Coverage HRA (ICHRA) if they are enrolled in Medicare Parts A and B. Supplemental plan premiums may also be eligible if permitted by the HRA.
QSEHRAs: A spouse’s employer group health plan premiums can also be reimbursed under a Qualified Small Employer HRA (QSEHRA) if both the employee and family meet the allowances. For 2026, the maximum annual QSEHRA reimbursements are $6,450 for individuals and $13,100 for families.
Required Documentation
To request reimbursement for a spouse’s Medicare premiums, the following documentation is typically required:
Proof of Medicare Enrollment: This includes the spouse’s Medicare card reflecting their enrollment in Parts A and B (if applicable).
Premium Invoice or Proof of Payment: A recent bill or invoice indicating the monthly premium amount.
Optional Supporting Documentation: For pension-deducted premiums or unique setups, upload benefits statements or any proof detailing the deduction.
Submission Process
The process of submitting a spouse’s Medicare premium reimbursement claim involves several steps:
Platform-Specific Addition: Register the spouse as a dependent on the employer’s chosen HRA platform (e.g., Take Command portal).
Uploading Documentation: Submit all required documents directly through the designated portal to verify eligibility and premium amounts.
Approval and Allocation: Once the claim is approved, the eligible amount will be included in the employee’s monthly reimbursement. Adjustments to the allowance may reflect the addition of the spouse.
Important Considerations
Separate Plans: A spouse’s Medicare premiums can still be reimbursed even if they are enrolled in a different plan than the employee (e.g., individual plan vs. family plan).
Plan Restrictions: HRAs like ICHRAs are subject to IRS regulations. They cannot reimburse premiums for spouses enrolled in group health plans through their employer.
Related Topics
Understanding HRA Types: ICHRA vs. QSEHRA
Required Steps for Adding Dependents to Your HRA Plan
Limitations on Employer-Sponsored Health Coverage
By following these procedures and providing the correct documentation, employees can smoothly get reimbursed for their spouses’ Medicare premiums through their employer's HRA.