While your employer can’t pay your Medicare premiums in the true sense, you’ll be glad to know that they may reimburse you for your premium costs! To compensate you, your employer will need to create a Section 105 Medical Reimbursement Plan. We’re here to help you understand your options for reimbursement of employer premiums you’ve paid.
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Can an Employer Pay My Medicare Supplement Premiums?
Medicare Supplement coverage can’t be paid directly by your employer. However, you can get a refund for your monthly premiums from your employer. But, your employer must have a Section 105 plan in place. They can’t write you a check for your Medigap coverage itself, but they CAN refund you for your monthly Medigap premiums, as long as they arrange a Section 105 plan.
There may be instances you can’t get a refund for your Medigap premium. This doesn’t mean you should default to your employer’s health coverage for secondary insurance. Many times, Medigap plans are less costly and provide a wider variety of coverage than your employer’s health plan.
How Medicare Premium Reimbursement Works with an Employer Section 105 Plan
A Medicare premium reimbursement is a fantastic way for active employees to get refunds of their premiums. Often, premiums may cost less than group insurance at your workplace. If you prefer Medicare to your group coverage, you may be eligible to get premium reimbursements. This depends on the program your company has in place. Further, keep in mind that being reimbursed by Medicare versus being reimbursed by your employer are two different topics.
What is a Section 105 Plan?
A Section 105 plan is a reimbursement health plan that lets companies repay employees for their medical costs on a tax-exempt basis. Although there are several different plan options, the most popular Section 105 program is a Health Reimbursement Arrangement plan.
Medicare Premium Reimbursement Arrangement
The type of Section 105 plans employers offers will depend on the employer’s size and whether they provide a group health plan. A Health Reimbursement Arrangement is a system covered by Section 105. This arrangement allows your employer to reimburse you for your premiums.
Some HRAs at employers that provide group coverage require that your employer’s payment plan ties in with the group health plan. Contact a human resources representative at your organization if you have questions about the plan offered to you.
We’ll explain two common types of HRAs offered by employers that can help with your Medicare premiums.
Individual Coverage Health Reimbursement Arrangement (ICHRA)
To be eligible for an Individual Coverage Health Reimbursement Arrangement, you’ll need Medicare Part A and Part B, or Medicare Part C. You can use the ICHRA to reimburse premiums for Medicare and Medigap as well as other costs.
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Employers have more choice in which medical costs are eligible for reimbursement under an ICHRA. The terms must be equal for all employees, and medical costs can’t be designed around what Medicare will or won’t pay.
If your employer offers an ICHRA, you must choose between the group policy option and having the ICHRA cover your Medicare costs.
Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)
If your organization employs fewer than 50 full-time workers and doesn’t offer a group health plan, it may provide a Qualified Small Employer Health Reimbursement Account. To take part in a QSEHRA, you must have minimum essential coverage (MEC), which means enrolling in Part A. Enrolling in only Part B doesn’t count as MEC, but enrolling in Part C does because it includes Part A benefits.
If you have MEC, a QSEHRA will reimburse almost all Medicare premiums; including Part D, Medigap, and Advantage. The only premiums that don’t qualify for reimbursement through a QSEHRA are Part A premiums. Most people do not have to pay these premiums but those who have worked fewer than 40 quarters must pay monthly.
Reimbursements under a QSEHRA are tax-free. If your workplace offers a QSEHRA, talk to a human resources representative about getting your premiums covered.
FAQs
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Can my Individual insurance premiums through Medicare Part B, Supplemental and Part C be reimbursed through my employer’s Section 125 POP Plan? Employer size is over 20.
Hi Vickie, great question! A Section 125 Plan cannot cover the costs of your Medicare part B premium or Medicare Supplement. However, if you have been participating in the Section 125 plan prior to receiving Medicare, it does lower your taxable income and could affect your Part B premium.
If we do have a section 105 plan and reimburse our employee for her Medicare premiums do I report this on her W2 anywhere?
Hi Patti – because medical reimbursements are not taxable, Section 105 plans don’t need to be reported on the W2.
I have a group that was recently acquired, and the owner is retiring. As part of the retirement package, the group has agreed to pay his health insurance. He has a Medicare Supplement plan through the employer. Can the group pay for this (not for his Medicare but the Supplement plan) pre-tax, or will that be post-tax to them? Is there an IRS publication that clarifies this? I’m pulling out my hair trying to document a response.
Lindsay,
I understand that IRS does not allow the large employer to use the HRA to pays for Medicare premium as it stated in the IRS Code.
The Code also allows for HRA to reimburse the employee for the other medical expenses such as Deductible, Copay, and etc.
Now, Can HRA reimburse the employee for a copay of Medicare Advantage if the plan has 0 premium?
Hi, Heady! Yes, an HRA can reimburse copays regardless if they are copays under Original Medicare or a Medicare Advantage plan.
Hello, I am about to go on Medicare Part A & B & D. I am self employed in a corporation that is a sub S corp. I am the president and only employee. The S Corp has never had an employee health plan because I took my health ins through my wife’s employers because it was our best cost as a family plan. I am required to switch to Medicare because my wife’s plan doesn’t allow us to stay past 65. Can I set up a sect 105 plan under the S Corp and reimburse myself for the part B & part D or reimburse myself for a Medicare Advantage plan? If so is the reimbursement a tax deductible expense to the S Corp and are any of the reimbursement taxable income to me if the S Corp reimburse me?
Hi Dale. I found some great information on HRAs and s-corporations for owners that should be able to help answer your question.
Hi Lindsay, I looked at the ICHRA rules and talked to some other people. It does not seem like that will work if I leave everyone else on the group plan. ICHRA has certain classes of employees needed to be divided into and cannot fit the Medicare person into a seperate class. I guess what I am struggling with is the exact type of HRA to set up for the Medicare person while leaving my Group Coverage and group coverage HRA in place. I read all types of things about being able to reimburse my Medicare person through a Section 105 plan, but cannot find any providers that say they can accomodate what I want to do.
I have a further question on this, similar scenario, six employees, five on group health plan, one on medicare. Since I am employer of less than 20 I can make the medicare-eligible employee ineligible for my group plan. Can I then set up ICHRA to reimburse the medicare employee and at the same time have a seperate integrated HRA coupled with my group health plan to help those employees offset deductible and coinsurance.
Hi Kirk! I was able to find some good overview information on ICHRA and how it works with Medicare. Hopefully, you can find the answer to your question there! I plan to do some more research on the topic and update this article accordingly. I hope this helps!
We have 5 employees. 3 will be on Medicare and 2 will remain on the company group health insurance plan. How can I reimburse the 3 employees on Medicare for their premiums? I read I cannot set up an HRA or 105 plan because we still have a Group Health Plan. The only way was for the 2 employees to shop for their own insurance, terminate the company group health and then we can reimburse through the HRA or 105 for all 5. Is that true? Our work around was to come up with a fair amount and make it a bonus through the payroll for the employees on Medicare. I cannot find the answer to this anywhere. Thank you,
Hi Geri! In most cases sure as yours, the company generally will have the employee pay their insurance and then submit the bill for re-reimbursement. Some carriers do allow 3rd party payment, and we would have to look in your area to see if there is anything available for that option. Keep in mind with Option 1 you can shop around for a more stable company and lower rate vs. option 2 where you are dictated by which companies allow 3rd party payments. I hope this helps!
Work for a company that has 20-22 employees and two health plan to choose from, a high deductible plan with an HRA component (the company pays a certain amount of out-of-pocket each plan year) and a traditional policy with co-pays and much smaller deductibles. Employees pay 40% of the cost via a S125 payroll reduction plan. One employee is turning 65 soon and the insurance company says this employee can no longer be on either plan since they are now Medicare eligible. This person is a HCE but not an owner. Can the company establish a S105 plan and reimburse the employee for Medicare costs and supplemental insurance?
Hi Bob! As long as the company has more than 20 employees, the employer coverage is considered creditable and the employee can stay on your plan even though they are eligible for Medicare. They can delay Part B until they retire without being penalized. I would check out our article on Medicare and employer coverage for more information. I hope this helps!
Can an individual, who’s employer does not offer group health and declines Medicaid (although eligible), claim tax deductions for the premiums of their individual health plan?
Hi Torrey! Yes, some Medicare premiums are tax-deductible.
I have a large group over 200 lives – they are not eligible for a Section 105 reimbursement of premium expenses if we offer to pay the employee’s MedicarePart B, D and Supp. Is there any other way an employer can offer to pay for EITHER the group health plan contributions OR a Med Supp and Part B & D? Thanks
Hi Gail! Unfortunately, without a 105 Reimbursement Plan, you won’t be able to contribute to your employees Medicare premiums. You can read more about Medicare and employer coverage here. You could always ask your benefits administrator to see if they know anything additional that would allow you to get around this. I hope this helps!
How should an employer go about setting up a section 105 plan so they can start reimbursing employees health insurance and/or medicare premiums? Would it be a good idea to have an attorney write up the plan or can an insurance agent do this?
Hi Bret! I believe you would have to do this through your benefits administrator, they should have the documents needed. If not, you would need to call Medicare directly to find out what the process is.
I receive social security disability and have had Medicare Part A since I became eligible. I opted out of Medicare Part B because I had group coverage through my husband’s employer. The cost of coverage through my husband’s employer went up significantly, and after doing some research, I enrolled in a Medicare Advantage Plan as of January 1, 2020. My question is: Can I now drop the coverage through my husband’s employer? And, do I have to notify my Medicare Advantage Plan carrier that I dropped it? I am unable to find anything specific regarding this.
Hi Janelle! This is a case by case scenario. You would need to contact your benefits administrator to get the answers. I would recommend reading our FAQ on Medicare Advantage vs. Medicare Supplements to make sure switching to an Advantage plan was the right decision. You have until the end of March to disenroll and switch to a Medigap plan if you choose to do so.
I retired in 2004, 16 years ago on Medicare. My employer was under a 105 medicare premium reimbursement plan. and did tell me about the program for 16 years. So i did not know that i should have been reimbursed for my medicare premiums over all those years. They said that according to their plan rules they only have to make 2 months worth of back payments which mean i must take a loss on 16 years of payments. I appreciate your insight on this because it does not seem right. To me these payments should have been initiated when i retired. In 2019 was the first year they asked for SSA verification of benefits for this purpose. I submitted the verification to them but they couldn’t find it. I submitted the 2020 verification and called to confirm receipt. This is when i found out this benefit was available.
Hi Jacqueline! Thank you for your question. I don’t have enough information to provide you with a straight forward answer. There are many different types of Section 105 plans offered through employers. They are all designed differently and have specific guidelines. If the plan rules have limits, such as only having to reimburse you for two months worth of back payments, then, unfortunately, there’s nothing you can do. However, there might be rules in place where your employer has to prove they told you about the section 105 plan upon employment and/or retirement. Hopefully, this helps!
I just noticed yesterday that my employer has been deducting Medicare f or 4 years. I have been receiving social security retirement since 2018.
Your INFO is greatly appreciated. I will go to payroll office and se what they can do form. For sure, stop deduction.
Did your employer return your portion of the Medicare expense to you?