Can a Retiree HRA Reimburse Medicare Premiums? (w/Examples) + FAQs

Yes. A retiree Health Reimbursement Arrangement (HRA) can reimburse Medicare premiums depending on the HRA type and plan design. Many Medicare-eligible retirees use former employer HRAs to cover Part B, Part D, and Medigap premiums on a tax-free basis, though some Medicare costs cannot be reimbursed. Understanding which premiums qualify, how to submit claims correctly, and what documentation you need prevents costly mistakes and ensures smooth reimbursement.

What You’ll Learn

🎯 Which Medicare premiums an HRA can and cannot reimburse, plus why Part A reimbursement has limits

💰 How the tax-free reimbursement works under federal law and why employer contributions avoid both payroll and income taxes

📋 Real-world scenarios showing exactly how reimbursement flows from your HRA to your insurance carrier, with step-by-step examples

⚠️ Common mistakes that delay or deny reimbursement claims—and how to avoid them completely

🔄 The difference between automatic premium reimbursement and manual filing, plus submission deadlines and documentation rules

The Core Problem: Medicare Costs and Retiree Benefits

Retirees face a major financial challenge when they move to Medicare. Unlike active employees covered by group health plans, retirees must pay Medicare premiums directly out of pocket. Federal law under Section 105 of the Internal Revenue Code created a solution: employers can fund an HRA specifically for retirees to reimburse these eligible costs. However, not all Medicare premiums qualify, and the rules vary significantly depending on whether you have an individual coverage HRA, a retiree HRA, or a post-separation HRA.

A 2024 survey found that approximately 40% of retirees ages 65-75 still rely on former employer health benefits, yet most are unsure which Medicare expenses their HRA covers.

Breaking Down HRA Types and Medicare Coverage

Traditional Retiree HRA functions as a post-separation benefit. Your former employer funds this account when you retire and meet eligibility requirements. Once claims-eligible, your HRA reimburses qualifying medical expenses. The critical legal fact is that post-separation HRAs make Medicare the primary payer, meaning Medicare pays first, then your HRA pays secondary benefits. This protects you from using HRA funds unnecessarily.

Individual Coverage HRA (ICHRA) is a newer arrangement created under 2020 rules. These HRAs reimburse individual health insurance premiums, including Medicare parts. ICHRA rules allow reimbursement for Medicare Part C, Part D, and Medigap premiums if you meet minimum essential coverage requirements (typically Parts A and B together or Part C alone).

Active Employee HRA with Medicare differs substantially. If you work part-time after retirement or remain employed past 65, your employer’s HRA is considered primary to Medicare under federal law. This means Medicare won’t pay until your HRA is exhausted. You can elect “limited HRA coverage” to make Medicare primary instead, protecting your HRA balance.

The practical consequence of these arrangements is that retirees must know their specific HRA type before submitting premium reimbursement claims. Submitting claims to the wrong HRA type or misunderstanding the payer order can result in claim denials.

Which Medicare Premiums Are Eligible for Reimbursement?

Eligible Medicare Premiums

Medicare Part B Premiums are reimbursable through most retiree HRAs. Part B covers doctor visits, outpatient care, and preventive services. The standard monthly Part B premium for 2025 is $174.70, but higher-income beneficiaries pay additional amounts called Income-Related Monthly Adjustment Amounts (IRMAA). Both the base premium and IRMAA surcharges are eligible for HRA reimbursement, meaning your HRA covers the full amount.

Medicare Part D Premiums cover prescription drug costs through private insurance companies. These premiums are also fully eligible. Like Part B, Part D premiums may include IRMAA surcharges for beneficiaries earning above income thresholds. Your HRA reimburses both the standard premium and any IRMAA addition.

Medicare Supplement (Medigap) Premiums fill gaps in Original Medicare coverage. Plans A through N offer different benefit levels, and premiums vary widely by plan and location—ranging from under $100 to over $300 monthly. Retiree HRAs and ICHRAs can reimburse Medigap premiums in full, though traditional group HRAs paired with active employee coverage typically cannot.

Medicare Advantage (Part C) Premiums are reimbursable through ICHRAs if you meet specific requirements. Part C is an alternative to Original Medicare offered by private insurers. To qualify for ICHRA reimbursement of Part C premiums, you must be enrolled in both Part A and Part B, or Part C alone satisfies requirements. If you have only Part B without Part A, your ICHRA cannot reimburse Part C costs.

Ineligible Medicare Premiums

Medicare Part A Premiums are generally not reimbursable. Most people receive free Part A coverage through their Social Security record or their spouse’s record. For the small percentage who must pay Part A premiums (typically those who didn’t pay enough taxes during their working years), retiree HRAs and traditional group HRAs cannot reimburse this cost. The legal reason is that payroll taxes automatically fund Part A, so the IRS does not classify Part A premiums as eligible medical expenses under the tax code. Only ICHRAs with specific plan language designed to accommodate Part A premiums can reimburse this cost, and most employer plans exclude it.

Medicare Part A premiums have a second limitation: if Part A coverage is automatic through Social Security, the cost is not a “medical care expense” under federal tax law, making reimbursement impossible regardless of HRA type.

How Retiree HRA Medicare Premium Reimbursement Works

The Mechanics: From Premium Payment to Reimbursement

Step 1: You Pay Your Medicare Premium — Each month, Medicare deducts Part B premiums from your Social Security check unless you’ve requested direct billing. Part D and Medigap premiums go to private insurers, and you pay them through direct billing, automatic deductions, or manual checks.

Step 2: You Gather Documentation — Collect proof that you paid the premium. For Part B and Part D, your Social Security “Cost of Living Statement” (typically mailed in October) shows your premium amounts. For Medigap, collect monthly statements from your insurance carrier showing payment confirmation.

Step 3: You Submit a Reimbursement Request — Your HRA administrator (often a third-party benefits company) has either an online portal or paper forms. You submit your request with documentation showing the premium type, carrier name, coverage period, amount, and proof of payment.

Step 4: HRA Administrator Verifies and Approves — The administrator confirms your HRA has sufficient funds, verifies the premium is eligible under your plan, and checks that documentation is complete. This typically takes 5-10 business days.

Step 5: Reimbursement Processes — Funds are deposited to your bank account or mailed as a check, usually within 90 days of approval. Reimbursements are tax-free to you and tax-deductible to your employer—neither you nor your former employer pays taxes on the reimbursed amount.

Automatic Premium Reimbursement: The Faster Route

Many HRA administrators now offer automatic premium reimbursement for eligible premiums. Instead of filing monthly claims, you submit a one-time authorization form. The administrator then automatically reimburses your premium each month as long as your account has sufficient funds and your premium amount stays the same.

Advantages of automatic reimbursement include no paperwork each month, faster processing since claims bypass manual review, and continuous coverage without missed deadlines. Monthly reimbursements occur within 5-7 business days of the premium due date.

Disadvantages occur if your premium changes (from IRMAA adjustments, plan changes, or carrier rate increases). You must notify your HRA administrator immediately, or excess reimbursements may be reported as taxable income on your federal return. If you forget to update your account and the administrator overpays for several months, you may owe taxes on the overage.

Real-World Scenarios: Three Retiree Examples

Scenario 1: Robert’s Straightforward Medicare B and Medigap Reimbursement

Decision	Outcome
Robert retired at 67 with a retiree HRA funded by his former employer.	HRA became claims-eligible immediately upon separation from employment.
His Medicare Part B premium is $174.70 per month; his Plan G Medigap is $285 monthly.	Total eligible monthly premiums = $459.70.
Robert’s HRA receives $500 monthly from his employer.	His $500 allowance fully covers both premiums with $40 monthly carryover.
Robert sets up automatic reimbursement through his HRA portal.	Each month, his reimbursement occurs automatically without filing claims.
After two years, Robert’s income increases; his IRMAA surcharge adds $69.70 to Part B.	New Part B cost = $244.40; Medigap stays $285; total = $529.40.
Robert’s HRA allowance remains $500.	Robert now pays $29.40 out of pocket monthly since the surcharge exceeds his allowance.
Robert contacts his HRA administrator to report the change.	The administrator adjusts his reimbursement to $244.40 for Part B and $255.60 for Medigap (totaling his $500 allowance).

The consequence: Robert must carefully monitor premium changes and IRMAA adjustments, notifying his HRA administrator when costs rise. Failure to update could result in underpayment, overpayment (creating tax liability), or coverage gaps.

Scenario 2: Linda’s Complex ICHRA with Part D and Medigap

Decision	Outcome
Linda’s employer closed their group plan and opened an ICHRA for all employees.	As a Medicare-eligible retiree, Linda had only Part A initially.
Linda needed Part B to meet ICHRA minimum essential coverage requirements.	She enrolled in Part B through a special enrollment period with no late penalties.
Her premiums: Part B = $174.70, Part D = $42, Medigap Plan N = $210.	Total = $426.70 monthly.
Her ICHRA allowance is $600 monthly.	Her allowance fully covers all three premiums with $173.30 carryover.
Linda submits proof of enrollment: Medicare premium bill, Part D carrier statement, and Medigap policy.	Documentation includes coverage periods, carrier names, and premium amounts.
Midyear, her Part B IRMAA increases by $95 due to higher income.	New Part B = $269.70; total premiums = $521.70.
Linda files an IRMAA appeal with Social Security, providing evidence of income reduction.	Social Security approves a one-year IRMAA reduction, bringing Part B back to $174.70.
After appeal approval, Linda notifies her ICHRA administrator of the change.	Her reimbursement adjusts, and she receives retroactive payment for the months of difference.

The consequence: Linda successfully reduced an IRMAA surcharge by providing documentation of changed circumstances. Retirees with significant income changes (from investment losses, inheritance, or business sale) can appeal IRMAA, but they must act quickly—appeals must be filed within 60 days of the notice date.

Scenario 3: Michael’s HRA Risk Due to Continued Employment

Decision	Outcome
Michael retired at 62 but kept a part-time job with the same company.	His employer’s active employee HRA remained his primary payer (not Medicare).
Michael enrolled in Medicare Part B at 65.	Under Medicare Secondary Payer rules, his HRA must pay before Medicare.
His Medicare Part B premium = $174.70; his active HRA allowance = $300/month.	His HRA covered his Part B premium and other eligible expenses.
After six months, Michael stops working entirely.	He is now a retiree, and his status changes.
Michael did not notify his HRA administrator of his separation.	The administrator still treated his HRA as active employee HRA, keeping it primary to Medicare.
Three months later, Michael’s HRA account balance hits $0 from claims.	Without knowing his HRA was primary, Michael assumed Medicare was paying. Medicare had been secondary all along.
Michael’s doctor bills Michael for unpaid deductibles, claiming Medicare should have paid.	Medicare actually paid secondary after HRA funds ran out, creating confusion and bill collection issues.
Michael contacts his HRA administrator and elects “limited HRA coverage.”	His HRA becomes secondary; Medicare is now primary, protecting his remaining HRA balance for true gaps in coverage.

The consequence: Continued employment after retirement creates HRA at-risk status. Michael lost months of HRA benefits because he didn’t understand the payer order rules. Once he separated completely and elected limited coverage, his HRA was protected. The legal rule is that post-separation HRAs automatically make Medicare primary, but in-service HRAs (where you still work for the employer) are primary to Medicare unless you elect limited coverage.

Mistakes to Avoid

Submitting incomplete documentation tops the list of claim denials. Your HRA administrator requires four pieces of information: the covered individual’s name, coverage period, insurance carrier name, and premium amount. Missing even one element triggers a claim rejection. You then have 45 days to resubmit with complete documentation. Many retirees lose this deadline and forfeit reimbursement for that month.

Failing to update automatic reimbursements when premiums change causes either overpayment (creating tax liability) or underpayment (leaving you with unexpected out-of-pocket costs). Your responsibility is to notify your HRA administrator within 30 days of any premium change from IRMAA adjustments, plan switches, or carrier rate changes.

Misunderstanding Medicare Part A reimbursement leads retirees to submit claims that will always be denied. Part A premiums are ineligible under most HRA plans because they’re funded through payroll taxes, not classified as a “medical expense” by the IRS. Submitting Part A claims repeatedly wastes time and creates administrator frustration with your account.

Submitting claims after the deadline forfeits the reimbursement entirely. Most HRAs require claims submission within 90 days of the end of the benefit year (typically the calendar year). If you wait until February to claim January expenses, you may miss the deadline entirely. Some plans allow a runout period extending to 180 days, but you must verify your specific plan documents.

Confusing HRA with HSA causes major problems. Health Savings Accounts (HSAs) cannot reimburse Medicare premiums or Medigap premiums—only HRAs can. If you have both an HRA and an HSA, using HSA funds for Medicare premiums will result in taxable withdrawals and penalties. Your HRA is the correct account for all Medicare premium reimbursements.

Providing proof of payment incorrectly delays processing. Acceptable proof includes a cancelled check (front and back), insurance company statement, or Social Security “Cost of Living Statement.” Screenshots from your bank account, email confirmations, or insurance carrier portals alone are typically insufficient. Documentation must clearly show the payee name, amount, date, and coverage period.

Forgetting to report status changes creates compliance issues. If you move states, change employment, enroll in COBRA, or become eligible for Medicare due to a disability unrelated to age, you must notify your HRA administrator. Changes in coverage status affect your HRA eligibility or reimbursement rules.

Do’s and Don’ts for Retiree HRA Medicare Premium Reimbursement

Do’s	Don’ts
Do verify your specific HRA type (retiree, ICHRA, or QSEHRA) before submitting any claims.	Don’t assume all Medicare premiums are reimbursable; Part A reimbursement has strict limitations.
Do set up automatic premium reimbursement if your HRA offers it; it eliminates monthly paperwork.	Don’t ignore premium changes from IRMAA adjustments; notify your administrator immediately.
Do keep copies of all documentation—premium statements, Social Security letters, proof of payment.	Don’t submit claims after the 90-day deadline; you’ll lose reimbursement for that expense.
Do use your HRA for Medicare premiums; don’t mistakenly use HSA funds, which creates taxable withdrawals.	Don’t wait until year-end to submit claims; process them monthly to avoid missing deadlines.
Do appeal IRMAA surcharges if your income has decreased; you may reduce your Medicare premiums.	Don’t pay Medicare premiums from your HRA account directly; reimburse yourself after paying the carrier.
Do elect “limited HRA coverage” if you continue working past retirement; it protects your HRA balance.	Don’t assume Medicare automatically pays if you have an active employee HRA; the HRA is primary.
Do coordinate benefits if you have a spouse on Medicare; both spouses may have separate HRA accounts.	Don’t forget to provide the insurance carrier name on your reimbursement claim; it’s required.
Do ask your HRA administrator how long reimbursements take; most process within 90 days of approval.	Don’t submit duplicate claims; verify the administrator received your previous claim before resubmitting.

Pros and Cons of Retiree HRA Medicare Premium Reimbursement

Pros	Cons
Tax-free reimbursement: You pay no income or payroll taxes on HRA reimbursements, maximizing your benefit dollars.	Limited eligibility: Part A premiums are ineligible, and coverage depends on HRA type and employer plan design.
Employer funding: Your former employer funds the HRA, so you’re not paying from personal savings for premiums.	Balance limitations: Once your HRA balance depletes, reimbursements stop, leaving you paying out of pocket.
Covers multiple premiums: A single HRA reimburses Part B, Part D, and Medigap, simplifying benefit management.	Premium change complexity: IRMAA surcharges and plan changes require ongoing monitoring and updates.
Automatic processing available: Many HRAs offer automatic premium reimbursement, eliminating monthly paperwork.	Deadline pressure: Missing the 90-day submission window forfeits reimbursement permanently.
Secondary payer advantage (post-separation HRAs): Medicare pays first, protecting your HRA balance for major expenses.	Active employment complication: Staying employed past retirement makes your HRA primary to Medicare, depleting funds faster.
Rollover flexibility: Many HRA plans allow unused funds to roll over to the next year, preserving your balance.	Plan closure risk: If your employer eliminates the HRA, future retirees lose the benefit, though existing retirees typically retain it.
Supplements Medicare gaps: HRA reimbursement for Medigap premiums fills coverage gaps in Original Medicare.	Documentation burden: Retirees must gather and organize proof of premium payment each month for manual reimbursement.
IRMAA appeal support: You can reduce IRMAA surcharges by appealing to Social Security if income decreases.	Compliance complexity: Retirees must understand Medicare coordination rules or face HRA at-risk status.

Key Entities and How They Interact

Your Former Employer funds your retiree HRA with contributions. The employer determines eligible expenses, annual allowance amounts, and plan rules. Federal law prohibits employers from using HRA funds to incentivize Medicare enrollment, so your employer cannot condition HRA participation on choosing Medicare over group coverage. Your employer’s role ends once retirement begins unless you’re covered by a VEBA (voluntary employees’ beneficiary association), which may extend HRA administration indefinitely.

Medicare and Social Security Administration (SSA) determine your IRMAA surcharges and set premium amounts. SSA uses your income from two years prior to calculate IRMAA, so 2025 premiums are based on your 2023 tax return. If circumstances change significantly (major income loss, spouse death, business sale), you can appeal IRMAA within 60 days of the notice date.

Your HRA Administrator (often a third-party company) processes your reimbursement claims, maintains your account balance, and ensures compliance with plan rules. The administrator verifies that premiums are eligible under your specific HRA plan before approving reimbursement. Examples of major administrators include HealthInvest, Via Benefits, Mercer Marketplace, and Transcure.

Your Insurance Carriers (Medicare, Part D insurer, Medigap insurer) send you premium statements and may file electronic claims with your HRA administrator through automatic premium reimbursement agreements. Not all carriers support automatic processing; some require manual filing.

Your Healthcare Providers typically play no role in HRA Medicare premium reimbursement. HRAs pay for insurance premiums, not medical services. However, if your HRA also reimburses deductibles and copays, providers may verify claims.

The interaction flows like this: Your employer contributes to your HRA account → You receive monthly HRA allowance → You pay Medicare premiums to carriers → You or your carrier submit proof to the HRA administrator → Administrator verifies eligibility and approves → Funds reimburse to your bank account tax-free.

Critical Legal Rules Governing HRA Medicare Reimbursement

Section 105 of the Internal Revenue Code creates the legal foundation. Section 105 allows employers to reimburse employees (including retirees) for medical care expenses without triggering federal income tax or FICA taxes. Medical care is broadly defined in Section 213(d) and includes insurance premiums, deductibles, copays, and other qualified healthcare costs. The consequence is that HRA reimbursements save both you and your employer taxes.

Medicare Secondary Payer (MSP) Rules govern payer order when someone has both Medicare and employer coverage. For post-separation HRAs, Medicare is secondary (pays after HRA). For in-service HRAs (active employees), the employer HRA is primary, and Medicare pays secondary. End-stage renal disease (ESRD) beneficiaries face a 30-month coordination period where the HRA is primary regardless of employment status.

Anti-Duplication Provisions prevent overlapping benefits. Your HRA cannot reimburse expenses already reimbursed by another plan (like a spouse’s coverage). If your spouse has group coverage and reimburses a family premium, your HRA cannot reimburse that same expense.

ICHRA Minimum Essential Coverage Rule requires Medicare-eligible employees to have both Part A and B or Part C to qualify for ICHRA reimbursement. Part B alone does not satisfy minimum essential coverage requirements, even if you’re enrolled in Part D. This rule prevents HRAs from incentivizing employees to avoid Medicare Part A enrollment.

ACA Health Insurance Reform restricts incentives to enroll in Medicare. Employers cannot condition group health plan participation on Medicare enrollment (i.e., “retire on Medicare and we’ll pay your HRA allowance, but stay in our group plan and get nothing”). Benefits must be offered on equal terms to all employees in a given class.

Details on Documentation and Claims Submission

For Medicare Part B and Part D Reimbursement, your Social Security “Cost of Living Statement” serves as the primary documentation. This statement, mailed in October or November each year, shows your Medicare Part B premium, any IRMAA surcharge, and Part D or Medicare Advantage premium information. You can also call Social Security at 1-800-772-1213 to request a current statement online or by mail. This single document satisfies proof of both the expense and the amount.

For Medigap Premium Reimbursement, collect your insurance carrier’s monthly billing statement. The statement must show the covered individual’s name, coverage period (month and year), policy number, plan name (e.g., Plan G), and monthly premium amount. Some carriers provide annual statements showing the premium for the entire year; a single annual statement satisfies proof for all 12 months.

For Automatic Premium Reimbursement Setup, submit a form authorizing the HRA administrator to reimburse premiums automatically each month. The form requires your name, HRA account number, covered individual names, carrier name, policy number, premium amount, and payment method (e.g., the 1st or 15th of the month). The administrator requests a minimum 10-day notice before the premium due date to ensure timely processing.

For Manual Reimbursement Claims, submit the appropriate claim form with supporting documentation. Required documentation includes:

Proof of coverage (policy document, carrier statement, or enrollment notice)
Proof of payment (cancelled check front and back, bank statement extract showing payment, or insurance company payment confirmation)
Completed claim form indicating the covered individual, expense type, and premium amount
Any applicable medical necessity documentation (e.g., for long-term care or dental)

Acceptable proof of payment includes a cleared check with both sides copied (showing payee and amount), a bank or credit card statement extract highlighting the payment to the insurance carrier, or a receipt from the insurance company. Screenshots and email confirmations alone are insufficient; the HRA administrator requires official documentation.

Claim submission deadlines depend on your plan. Most HRAs allow claims submission anytime during the benefit year (typically January through December). After the year ends, you have a 90-day runout period to submit claims for expenses incurred during the benefit year. Missing the 90-day deadline forfeits reimbursement permanently, even if the expense was valid.

Processing timelines vary. The HRA administrator typically processes complete and accurate claims within 5-10 business days. Incomplete claims may be denied, giving you 45 days to resubmit with additional information. After approval, reimbursement is deposited to your bank account or mailed as a check within an additional 90 days.

Tax Implications and IRMAA Coordination

Tax-Free Nature of HRA Reimbursements means the reimbursement amount is not added to your income, does not trigger federal income tax withholding, and does not affect your tax return. Neither you nor your former employer reports HRA reimbursements on Form 1099 or includes them in gross income. This is a significant advantage compared to taxable wage increases.

IRMAA and HRA Coordination requires careful planning. IRMAA is calculated on your Modified Adjusted Gross Income (MAGI) from your tax return from two years prior. If you receive large distributions from retirement accounts, capital gains, or other income sources, your IRMAA may increase substantially two years later. Unlike some benefits, IRMAA increases are not considered a “life-changing event” for appeal purposes unless your income permanently declined (e.g., retirement from work, business sale at a loss, investment losses).

IRMAA Appeals and Documentation allow you to reduce surcharges if circumstances changed. Acceptable life-changing events include retirement, reduction in hours worked, divorce, death of a spouse, loss of investment income, or business loss. To appeal, you must contact Social Security within 60 days of receiving the IRMAA notice and provide evidence of the changed circumstance (e.g., letter from employer confirming retirement, divorce decree, or 2024 tax return showing lower income).

Interaction with Tax Return Filing becomes important if you have multiple premium payments from different sources. If your spouse has group coverage that reimburses some premiums and your HRA reimburses others, ensure you’re not double-counting deductions. Amounts reimbursed tax-free through your HRA cannot be deducted again on your tax return.

FAQs

Q: Can my HRA reimburse my spouse’s Medicare premiums?

A: Yes—if your spouse is covered under your HRA plan. Some employer HRAs cover only the retiree; others extend to spouses. Check your plan documents or contact your HRA administrator. If your spouse has a separate HRA through their employer, they use their own account for their premiums.

Q: What if I enroll in Medicare late? Does my HRA cover late enrollment penalties?

A: No—late enrollment penalties are not eligible for HRA reimbursement because they’re considered punitive, not medical expenses. Enroll in Part B within three months of retirement to avoid penalties. Your Part D late enrollment penalty is also ineligible.

Q: If I have an HSA and an HRA, which account do I use for Medicare premiums?

A: Use your HRA only. HSAs cannot reimburse Medicare premiums or Medigap premiums. Using your HSA for these expenses triggers a 20% penalty plus income taxes on the withdrawal. Once you enroll in Medicare, you cannot make new HSA contributions anyway.

Q: Does my HRA cover Medicare deductibles and copays?

A: It depends on plan design. Some HRAs reimburse only premiums; others reimburse premiums plus deductibles, copays, and out-of-pocket expenses. Check your plan documents. If your HRA reimburses expenses, deductibles and copays are eligible medical expenses.

Q: Can I submit claims for premiums my employer paid directly?

A: No—your HRA reimburses your premium payments to the carrier, not employer payments to you. If your employer paid the premium directly to the insurance company, no reimbursement occurs; the benefit is already provided.

Q: How long does HRA reimbursement take?

A: 5-10 business days for processing, plus up to 90 days from approval for funds to reach your bank account. Automatic premium reimbursement is faster, typically depositing within 5-7 days. Manual reimbursements take longer due to verification requirements.

Q: My IRMAA increased. Can I appeal, and does my HRA cover the increase?

A: Yes, you can appeal if circumstances changed. Your HRA reimburses IRMAA surcharges (both the base premium and the surcharge), so yes, your HRA covers the increase. To reduce the surcharge itself, contact Social Security within 60 days of the IRMAA notice with evidence of income reduction.

Q: If my HRA runs out of funds mid-year, what happens to my premiums?

A: You pay out of pocket until the plan year ends or employer contributions resume. Some employers replenish HRA accounts; others do not. Contact your employer to ask if additional contributions are possible.

Q: Can my HRA reimburse Medigap premiums if I also have Medicare Advantage?

A: No—if you’re enrolled in Medicare Advantage (Part C), you’ve replaced Original Medicare and don’t need Medigap. Your HRA can reimburse either Part C premiums or Medigap premiums, but not both simultaneously.

Q: What documentation do I need for manual Part D premium reimbursement?

A: Your Part D carrier statement showing the covered individual, coverage period, plan name, carrier name, and monthly premium amount. Additionally, provide proof of payment—a cleared check or insurance company payment confirmation. Your Social Security statement does not show Part D details for non-employer plans.

Q: If I switch Medigap plans mid-year, does my HRA reimburse both plans?

A: Yes, but only the premiums for the active coverage period. Reimbursement for January through June under Plan F and July through December under Plan G is eligible. Submit separate claims for each plan with proof that you were actively enrolled during those months.

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