A qualified medical expense is a healthcare cost that can be paid or reimbursed using your ICHRA funds. These are expenses related to your medical care, including treatment, prevention, and care management, that are recognized under IRS rules.
Your employers ICHRA may cover health insurance premiums only, or it may cover both health insurance premiums and qualified medical expenses. Check with your employer or review your employer’s ICHRA notice if you’re unsure.
Common Examples of Qualified Medical Expenses
Qualified medical expenses generally include costs for:
- Health insurance premiums (if your employer’s ICHRA allows)
- Doctor visits and co-pays
- Prescription medications
- Dental and vision care (including exams, procedures, and glasses or contacts)
- Medical equipment and supplies (like crutches, blood pressure monitors, or hearing aids)
- Mental health services (counseling, therapy sessions)
- Hospital services and lab tests
Please refer to IRS Publication 502 for a full breakdown of qualified medical expense.
Expenses That Are Usually Not Qualified
Certain expenses do not qualify for reimbursement, including:
- Cosmetic procedures (like teeth whitening or plastic surgery for appearance)
- Over-the-counter medications without a prescription (unless allowed by plan rules)
- Health club memberships or fitness classes
- Non-medical personal items
If you’re ever unsure whether a particular expense is eligible, submit it through BEN360 or reach out to your licensed benefits counselor for guidance.