How Does an HRA Work?

Well being reimbursement preparations (HRAs) are advantages that some employers provide their staff to assist with healthcare bills. They’re a manner for corporations to reimburse employees for these prices, and reimbursements are typically tax-free when used for certified medical bills.

Since January 2020, the federal government has allowed employers to supply their staff two kinds of HRAs. The primary is known as a person protection HRA, and firms can solely provide it if they do not provide group medical insurance.

Workers can use these HRAs to purchase their very own complete medical insurance with pretax {dollars} both on or off the Well being Insurance coverage Market. Particular person protection HRAs can even reimburse staff for certified well being bills akin to copayments and deductibles.

How a lot employers contribute to staff’ particular person protection HRAs is as much as the employers, besides that every one employees in the identical class of staff should obtain the identical contribution. Staff who’re older or who’ve dependents might obtain extra.

Underneath the brand new guidelines, employers that proceed to supply conventional group medical insurance can even provide the second, new kind: excepted profit HRAs. These plans reimburse staff for as much as $1,800 a yr 2022 and $1,950 for 2023 in certified medical bills.

Workers can enroll in an excepted profit HRA even when they refuse group medical insurance protection, however they can not use the funds to purchase complete medical insurance. They’ll, nonetheless, use the funds to pay for short-term medical insurance, dental and imaginative and prescient premiums, and certified medical bills.


Key Takeaways

  • Since January 2020, employers of all sizes have been in a position to reimburse their staff for a number of the value of shopping for particular person medical insurance plans as a substitute of providing group medical insurance.
  • These reimbursement preparations, known as particular person protection HRAs, can even pay staff again for certified medical bills akin to coinsurance and deductibles.
  • Employers who proceed to supply group protection can also provide their staff excepted profit HRAs to reimburse staff for certified medical bills however not for complete medical insurance premiums.
  • The HRA restrict in 2022 is $1,800; in 2023 it will increase to $1,950.

Who Funds an HRA?

HRAs are funded completely by employer cash. An HRA will not be an account (although you may even see it mistakenly referred to that manner). It’s a reimbursement association between worker and employer. Workers can’t make investments the stability, and it doesn’t earn curiosity. Should you take part in an HRA, you received’t see any deductions out of your paycheck.

As an alternative, your employer decides how a lot it’s keen to reimburse you for healthcare prices on a month-to-month or annual foundation. Should you nonetheless have a stability on the finish of the yr, it might roll over to the following yr so long as your employer continues to supply the HRA and also you proceed to take part, however it additionally might not: that call is as much as your employer, too.

Tips on how to Take part

To take part in an HRA, you have to decide in throughout your employer’s open enrollment interval. You probably have a qualifying life occasion, you’ll be able to join exterior of open enrollment. Spouses and youngsters who take part in your employer’s medical insurance plan can be reimbursed via an HRA. Sadly, in case you’re self-employed, you’ll be able to’t use an HRA.

The IRS allowed employers extra flexibility with their profit plans through the COVID-19 disaster. An worker could make a brand new election in the event that they initially declined to elect employer-sponsored well being protection; revoke an current election and make a brand new election to enroll in numerous well being protection sponsored by the identical employer; and revoke an current election, offered that the worker attests in writing that they’re enrolled, or will instantly enroll, in different well being protection not sponsored by the employer. All these provisions are completely on the discretion of the employer.

Reimbursable Bills

It’s as much as your employer to determine which of your bills to reimburse. The expense should be a professional medical expense listed in IRS Publication 502, however your employer can use a narrower record. Normally, staff can use an HRA to be reimbursed for certified medical bills their medical insurance doesn’t pay for, akin to medical and pharmacy bills they have to pay out of pocket earlier than assembly a deductible, in addition to a coinsurance that applies after assembly a deductible. 

Certified medical bills embody prices akin to physician’s workplace visits, X-rays, or surgical procedure. Dental and imaginative and prescient bills normally qualify, too, as do a number of over-the-counter objects, akin to diabetes-testing aids, blood-pressure screens, and contact-lens options.

Employers can’t allow you to use HRA funds for issues the IRS doesn’t enable, although. You’ll be able to’t use an HRA for over-the-counter medicines until your physician has prescribed them. You can also’t use an HRA to be reimbursed for prices you incurred earlier than your HRA participation turned efficient or for prices from a distinct yr.


The common annual premium for a high-deductible well being plan (HDHP)/HRA for a household in 2021 was $21,662; the typical for a single particular person was $7,441.

Reimbursement Logistics

Your HRA administrator will usually have the ability to confirm your declare mechanically, however typically you’ll have to submit an itemized invoice out of your healthcare supplier to substantiate your declare. By legislation, no expense is simply too small to be reimbursed, however your employer would possibly require you to build up a minimal quantity of reimbursable bills earlier than it is going to subject a test. 

Your employer chooses the way it will reimburse you for certified medical bills. You might obtain a debit card so you’ll be able to pay on your bills as wanted, or you could have to pay up entrance, then request reimbursement. Some plans will reimburse your physician straight, so that you don’t want to make use of a debit card or wait to get your a reimbursement. 

The utmost you could be reimbursed per yr is no matter your employer decides. In case your employer permits it, you could possibly spend the quantity remaining in your HRA inside a restricted interval in case you are terminated.

Tax Advantages

You don’t need to report your participation in an HRA in your tax return. The quantity your employer is keen to reimburse you for medical bills via an HRA will not be thought of taxable revenue, nor are the precise quantities reimbursed, so long as you place the cash towards certified medical bills as outlined by the IRS and your employer. 

Exceptions to tax-free distributions apply in a number of conditions: In case your employer pays out your unused reimbursements on the finish of the yr or whenever you depart your job, the cash can be thought of taxable revenue. As a result of it’s not getting used to reimburse you for certified medical bills, it’s handled as bizarre revenue.

Utilizing an HRA With an HSA or FSA

Are you able to mix an HRA with a Well being Financial savings Account (HSA) or versatile spending account (FSA)? Earlier than answering that query, it is vital to make clear the which means of those two kinds of accounts. Medical health insurance phrases can get complicated, so this is a fast reminder:

  1. HSAs should be used with a high-deductible well being plan (HDHP). Contributions can come from each employers and staff, the stability could be invested and rolled over from yr to yr, and the account goes with you whenever you change jobs. These accounts can be helpful as retirement financial savings autos.
  2. FSAs don’t have for use with an HDHP. Contributions come solely from worker payroll deductions, and the stability can’t be invested and doesn’t earn curiosity. FSA funds should be spent within the present plan yr, although some employers enable small quantities to roll over or give staff a grace interval at first of the next yr to make use of up the stability. Additionally, FSAs don’t go along with you whenever you change jobs.

The query is if in case you have each an HRA and an FSA, which account must you use to pay for a given medical expense? If an expense is simply coated by one account or the opposite, you may have your reply. If it’s eligible to be paid from both account, you’ll have to know your employer’s guidelines about which account pays first. It most likely goes with out saying, however you’ll be able to’t double-dip and be reimbursed for a similar expense from each accounts.

What Are the Drawbacks of an HRA?

The employer who establishes the HRA has many of the management over it. They dictate how a lot cash goes into the plan, whether or not it could actually roll over from one yr to the following, and what makes use of of the funds are allowed. Normally, prices that are not deemed crucial or non-prescribed therapies or medicine aren’t eligible. Additionally, because the title well being reimbursement association suggests, you’ll be able to’t withdraw cash to pay for fees. You are solely paid again for bills after you incur them.

What Are the Variations Between HSAs, HRAs, and FSAs?

All three provide tax advantages associated to paying well being and medical prices. However an HSA is funded completely by the person, whereas an HRA is funded by the employer. An FSA could be funded by both or each (although it is normally simply the worker who does). HRA funds can cowl insurance coverage premiums; the opposite two cannot. You’ll be able to hold an HSA even in case you depart your job; typically, the opposite two keep along with your employer (although they might allow you to spend any remaining HRA funds via the top of the yr).

Can I Use an HRA and an FSA?

Sure, it’s doable to have each an HRA and an FSA. Should you do, nice—that’s much more untaxed revenue you should utilize for medical bills. You’ll be able to contribute as much as $2,850 to an FSA in 2022 (rising to $3,050 in 2023), and your employer will take that cash out of your paycheck. Nevertheless, do notice that generally, you can’t use an HRA together with an HSA.

The Backside Line

In case your employer gives you a brand new kind of HRA known as a person protection HRA as a substitute of group medical insurance, you may obtain tax-free reimbursement for the premiums you pay for the great medical insurance you buy on or off the trade. You can too get reimbursed for certified medical bills akin to coinsurance and the payments you pay earlier than you meet your deductible.

HRAs can range considerably from one employer to the following when it comes to how a lot protection they provide and which bills can be reimbursed. So though this text has offered a broad overview of what to anticipate, you’ll wish to learn your employer’s abstract plan description of its HRA, if it gives one, to get the main points.