Reimbursing Medical Expenses

In addition to individual health insurance premiums, ICHRA funds can reimburse employees for qualified medical expenses as defined by IRS Section 213(d). These expenses include, but are not limited to, the following:

• Prescription medications
• Doctor’s office visits and copays
• Dental care (excluding cosmetic procedures)
• Vision care (including eyeglasses and contact lenses)
• Medical supplies and equipment (such as crutches or wheelchairs)
• Mental health counseling
• Physical therapy

A comprehensive list of eligible medical expenses can be found in IRS Publication 502.

It’s essential to note that some expenses are NOT eligible for reimbursement under an ICHRA plan. These expenses include:

• Group health insurance premiums
• Expenses that have been reimbursed by another source (such as an FSA or HSA)
• Over-the-counter medications without a prescription (except insulin)
• Cosmetic procedures (unless medically necessary)
• Health club memberships (unless prescribed by a doctor for a specific medical condition)