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QSEHRA and Medicare Premiums


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Business has a premium only QSEHRA just covering health insurance premiums and not dental, vision premiums etc. An employee will be going on Medicare soon. While I know Medicare part B, Medicare Advantage (part C), part D, and Medicare Supplemental premiums may be reimbursed under QSEHRAs, is it fair to cover the supplemental/voluntary medicare premiums like Part D or medigap premiums for this employee if we only cover primary health insurance premiums for employees with market place or other health insurance coverage? Would that be considered a difference in how we are treating employees with market place coverage vs. an employee on Medicare? Or would that mean we should permit employees who do not use the full amount of the reimbursement amount if they have marketplace coverage (say if they are young with a relatively lower premium) to use the "extra" amount toward supplemental health insurance too if they so wish?

Would it be safer to just reimburse the employee's Part B premiums and/or Medicare Advantage premiums, but not supplemental premiums such as Part D and medigap?

Or should we amend the plan document to be more specific as to what premiums are covered and which ones are not?

Thank you.

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Fair?  Depends how one defines fair.

Given that the sum of Part B, Part D and MediGap premiums is usually less than the premium for pre-Medicare medical coverage (which presumably covers Rx, no?), I'm not sure why it would be "unfair" to pay/reimburse all of them.

Note that Part B is optional, too.  Also many MA (Part C) plans would be considered a combo of Parts A, B and MedSupp, and for the ones that include Rx, Part D, as well.  The point being, I am not seeing the logic of the slicing and dicing of what's fair and what's not as it is being posed above.

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