ICHRA AND MEDICARE SERVICES

How can you complete the Medicare side of your ICHRA experience?

ICHRA gives employees more control over coverage. Medicare eligibility introduces a different set of questions. Exact Benefits gives participants a connected path to education, individual guidance, enrollment support, and ongoing service.

WHAT IS ICHRA HEALTH INSURANCE?

What is ICHRA health insurance, and why does Medicare need a different path?

An Individual Coverage Health Reimbursement Arrangement allows an employer to reimburse eligible employees for qualifying individual coverage instead of offering one traditional group health plan.

Most ICHRA experiences are built around individual-market education, quoting, enrollment, and reimbursement. Medicare-eligible participants follow different rules and often need more personal support. Without a defined Medicare workflow, they can be sent to an unrelated call center with little continuity or visibility. Review the IRS overview of Health Reimbursement Arrangements.

ICHRA SUPPORT BY ROLE

Which ICHRA support path fits your role?

ICHRA MEDICARE JOURNEY

What does a connected ICHRA Medicare journey look like?

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ICHRA education before Medicare eligibility

Help participants understand how an ICHRA works and when Medicare may become part of their coverage decision.

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Individual Medicare consultation

Review coverage timing, doctors, prescriptions, budget, and household needs with a licensed specialist.

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Medicare enrollment support

Coordinate the participant's selected Medicare path and explain the information needed for ICHRA reimbursement.

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Ongoing participant service

Give employees a named resource for questions after enrollment while keeping partners informed at the appropriate level.

NATIONWIDE MEDICARE SUPPORT

How do you support a distributed ICHRA population without regional referral gaps?

A distributed workforce should not require a patchwork of regional Medicare referrals. Exact provides one support model for Medicare-eligible participants across the country, subject to approved licensing and carrier language.

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Dedicated Medicare scheduling

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Phone and video consultations

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Named partner contacts

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Co-branded participant education

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Approved status reporting

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Other ICHRA Services

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Administrators & Platforms

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Ichra for Medicare

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Brokers & PEOs

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Employers & Employees

FAQs

What should you know about ICHRA and Medicare?

Can an ICHRA reimburse Medicare premiums?

Certain Medicare premiums may be eligible when the arrangement is properly designed and the participant meets applicable requirements. The plan administrator and current guidance control the final determination. Review the official CMS guidance on ICHRA eligibility and Medicare.

Does Exact administer the ICHRA?

No. Exact supplies the specialized Medicare education, consultation, and enrollment-support layer alongside the administrator or platform.

Does a participant have to use Exact?

No. Exact provides a voluntary education and support path while the participant remains in control of where they receive licensed guidance.

What can partners see after a referral?

Partners receive only the status information and workflow visibility approved by product, privacy, compliance, and contractual requirements.

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