Eligible expenses are determined by your employer’s HRA plan design. To see what’s eligible for your plan:
- From your dashboard, click View Plan Details
- Look for Eligible Expenses under Eligibility & Coverage
Your HRA will cover one of the following four options
- Premiums Only
Your HRA reimburses insurance premiums (medical, dental, and vision) only. Out-of-pocket medical expenses are not eligible - Premiums + Other Medical Expenses
- Premiums for medical, dental, and vision insurance
- Other medical expenses are defined by IRS §213(d), which broadly includes expenses for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body - Premiums only (excluding taxable premiums)
Same as Premiums Only above, except certain taxable premiums are excluded. - Premiums + Other Medical Expenses (excluding taxable premiums) Same as Premiums + Other Medical Expenses above, except certain taxable premiums are excluded.
More On Other Medical Expenses
There is no definitive list of qualifying expenses. Broadly speaking, the following are commonly eligible:
- Deductibles, copays, and coinsurance
- Prescriptions
- Out-of-pocket dental and vision expenses
- Over-the-counter items like cold & flu medicine and feminine care products
Common items that do not qualify:
- Vitamins or supplements (unless prescribed by a doctor)
- Gym or fitness memberships
- Cosmetic procedures
If there’s any question about a specific expense, a good rule of thumb is to search:
“Is [expense] HRA, HSA, or FSA eligible?”
What are “taxable premiums”?
In a QSEHRA, some insurance premiums may be considered taxable and excluded by the plan. This most commonly applies when:
- You’re covered under a spouse’s or parent’s employer plan, and
- That coverage is paid pre-tax through a cafeteria (Section 125) plan
When taxable premiums are excluded, you may still be able to use the HRA for other eligible medical expenses, if permitted by your plan’s setup.
