Spouse Medicare premiums may be reimbursable through an ICHRA or QSEHRA if the spouse is an eligible dependent under the HRA and the employer's plan design allows dependent expenses to be reimbursed.
Are spouse Medicare premiums eligible for reimbursement?
Yes, if the spouse is an eligible dependent under your HRA
Spouse Medicare premiums are generally eligible for reimbursement when:
The spouse qualifies as your tax dependent or eligible covered family member under the HRA
Your employer's HRA allows reimbursement of dependent expenses
The Medicare premiums are incurred during an eligible coverage period
Required documentation is provided
Eligible Medicare premiums may include:
Medicare Part B premiums
Medicare Part D prescription drug premiums
Medicare Advantage (Part C) premiums
Medicare Supplement (Medigap) premiums
ICHRA: 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.
QSEHRA: 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.
When spouse Medicare premiums are not eligible
Reimbursement may not be available in certain situations
Spouse Medicare premiums may not be reimbursable if:
The spouse is not an eligible dependent under the HRA
The employer's plan only reimburses employee expenses
Required documentation is missing
The premium was incurred outside the eligible plan period
If any of these conditions apply, reimbursement may be denied.
What documentation is required?
Employees must provide proof of both coverage and premium amount
Acceptable documentation generally includes:
Proof of Medicare enrollment
Examples:
Medicare card
Medicare enrollment letter
Medicare Advantage enrollment confirmation
Proof of premium amount
Examples:
Social Security benefit statement showing Medicare deductions
Medicare billing statement
Carrier invoice for Medicare Advantage or Medigap coverage
Premium payment confirmation
Documentation must clearly show:
Name of the covered individual
Coverage type
Premium amount
Coverage period
How to submit spouse Medicare premiums for reimbursement
Follow these steps in your employee portal
Step 1: Log in
Sign in to your Take Command employee account.
Step 2: Navigate to reimbursements
Open the reimbursement or claims section of your account.
Step 3: Submit the premium documentation
Upload:
Proof of Medicare enrollment
Documentation showing the premium amount
Any additional information requested during submission
Step 4: Verify dependent information
Confirm that your spouse is listed correctly as an eligible dependent if required by your employer's plan.
Step 5: Submit the request
Review the information and submit the reimbursement request for processing.
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 ICHRA are subject to IRS regulations. They cannot reimburse premiums for spouses enrolled in group health plans through their employer.