Medicare Solutions Debit Card

Employers need options to help older (65+) employees and retirees save on healthcare costs.

Medicare is often the best option for employees and retirees older than 65, but federal regulations prohibit employers from making direct premium payments for Medicare or Medicare-related coverages.

Fortunately, employers have options that do meet federal guidelines:

  • Employer-sponsored Medicare Advantage Employer Group Waiver Plans (EGWPs) for retirees come with certain requirements by the Center for Medicare and Medicaid Services (CMS).
  • Health Reimbursement Arrangements (HRAs) give active employees and retirees a way to receive reimbursements for premiums and medical expenses.
Medicare Solutions Debit Card

Employer-Sponsored Medicare Advantage Plan

Instead of reimbursing retirees for premiums and out-of-pocket expenses, companies may choose to offer an employer-sponsored Medicare Advantage EGWP plan to provide coverage under Medicare Parts C and D (aka Parts A, B, and D).

Here’s how EGWPs work: The employer negotiates with their insurance carrier to design a private Medicare Advantage plan for their retirees. The Medicare Advantage plan must follow all Medicare Parts C and D requirements except for those explicitly waived by CMS. Then, just as it does for private individuals choosing a commercial Medicare Advantage plan, the federal government pays the insurance carrier a set amount for each plan enrollee.

Due to the CMS waivers, EGWPs can set their own enrollment periods and send information to members without prior CMS approval. They also have fewer provider network requirements, among other relaxed mandates.

HRA Reimbursement Plans

By establishing an ICHRA or QSEHRA plan, employers can reimburse active employees and retirees for the healthcare premium costs they incur, such as:

  • Medicare Part B (medical care)
  • Medicare Part D (prescription drugs)
  • Medicare Advantage (aka Medicare Part C)
  • Medigap/Medicare Supplement
  • Private health insurance coverage

ICHRA plans can reimburse premiums for Medicare Parts B and D, Medicare Advantage, and Medigap/Medicare Supplement coverage, as well as private health insurance coverage.

QSEHRA plan reimbursement requires that the employee have Minimum Essential Coverage (MEC), which can be met by either Medicare Part A or Medicare Advantage. QSEHRA funds can then reimburse premiums for Medicare Parts B and D, Medicare Advantage, and Medigap/Medicare Supplement coverages, in addition to private health insurance coverage.

Depending on plan setup, either of these HRA plan types can incorporate one of our benefits debit cards – the Summit card or the COMPASS™ card – to use with eligible healthcare expenses such as:

Medicare Solutions Debit Card

Copays

Coinsurance

Coinsurance

Medicare Solutions Debit Card

Deductibles

Dental, vision, and hearing care

Dental, vision, and hearing care

Medicare Solutions Debit Card

Over-the-counter medications

Security and Experience

Whether your administrative platform is proprietary or from a vendor whose card processing services don’t meet your needs, you can use DataPath’s benefits debit cards and card processing solutions with any of the Medicare-related programs referenced on this webpage.

Medicare Solutions in Summary

feature

ichra

qsehra

EGWP

Can be used with active employees aged 65+ of any sized company

X

X

Can be used with active employees 65+ by companies that have less than 50 employees

X

X

Can be used with retiree plans

Can reimburse premiums

X

Has an annual premium reimbursement limit

X

X

Can provide Medicare Advantage coverage to company retirees

X

X

Can pay or reimburse qualified medical expenses, either with or without a linked debit card