Many people assume Medicare is automatically low-cost once they turn 65. But for some seniors, Medicare premiums can become a major monthly expense.
In 2026, the standard Medicare Part B premium is $202.90 per month, and some people pay more depending on their income. Prescription drug coverage, Medicare Supplement premiums, and other out-of-pocket costs can also add up quickly.
The good news is that there may be ways to lower your Medicare-related costs, especially if you are still working, your spouse is still working, or you recently retired with employer benefits.
One option many people overlook is whether their employer offers a Health Reimbursement Arrangement, also known as an HRA. Some HRAs, such as an ICHRA or QSEHRA, may reimburse eligible healthcare expenses, including certain insurance premiums. CMS explains that individual coverage HRAs can reimburse premiums for individual health insurance, and CMS guidance also says ICHRAs may reimburse premiums and cost sharing for Medicare when the employee has Medicare Parts A and B or Medicare Part C.
Want Help Reviewing Your Medicare Costs?
If you are still working, recently retired, or covered through a spouse’s employer, do not guess your way through Medicare.
Call Medicare Plan Assistance today to review your options.
Call Now: 561-808-9410
Why Are Medicare Premiums So Expensive for Some People?
Your Medicare costs may include several different pieces:
- Medicare Part B premium
- Medicare Part D prescription drug premium
- Medicare Advantage plan premium, if any
- Medicare Supplement premium, if any
- Deductibles, copays, and coinsurance
- Higher-income IRMAA charges
- Prescription drug costs
Even if you have a $0 premium Medicare Advantage plan, you may still pay the monthly Medicare Part B premium. Medicare.gov states that Part B costs $202.90 per month in 2026, or higher depending on income.
That is why lowering Medicare costs is not always about finding one “cheaper plan.” Sometimes it means checking every available source of assistance, including employer reimbursement, Medicare Savings Programs, Extra Help, and IRMAA reduction requests.
If You Are Still Working, Start With Your Employer Benefits
If you or your spouse are still working, your employer benefits may affect your Medicare decisions.
Medicare.gov says that if you or your spouse are still working and have health insurance from a job, you may be able to wait to sign up for Medicare without paying a late enrollment penalty, depending on the coverage and employer situation.
But even if you do enroll in Medicare, you should ask your employer or benefits department one important question:
“Do we offer an HRA, QSEHRA, ICHRA, or retiree reimbursement account that can reimburse Medicare premiums?”
This one question could potentially save you money.
Still Working Past 65?
Before enrolling, delaying, or changing Medicare coverage, speak with someone who understands how employer coverage and Medicare work together.
Call Medicare Plan Assistance: 561-808-9410
What Is an HRA?
An HRA, or Health Reimbursement Arrangement, is an employer-funded benefit that can reimburse employees for certain healthcare expenses.
Unlike a health savings account, an HRA is funded by the employer. The employer decides what type of HRA to offer, who is eligible, and what expenses can be reimbursed under the plan rules.
Two common types are:
1. QSEHRA
A Qualified Small Employer Health Reimbursement Arrangement is generally used by certain small employers with fewer than 50 employees that do not offer a group health plan. Healthcare.gov says a QSEHRA allows eligible small employers to provide non-taxed reimbursement for certain healthcare costs, such as health insurance premiums and coinsurance, for employees who maintain minimum essential coverage.
2. ICHRA
An Individual Coverage Health Reimbursement Arrangement allows employers to reimburse employees for medical expenses, including premiums, when the employee has qualifying individual coverage. Healthcare.gov explains that individual coverage HRAs can reimburse medical expenses such as premiums, deductibles, and copayments.
For Medicare-eligible employees, CMS guidance says an ICHRA can require covered individuals to be enrolled in individual health insurance coverage or Medicare Parts A and B, or Medicare Part C, in order to receive reimbursements. It also says reimbursements may include premiums and cost sharing for Medicare.
Can an Employer Reimburse Medicare Part B Premiums?
In some situations, yes.
If your employer offers the right type of HRA or retiree reimbursement arrangement, you may be able to submit proof of your Medicare premium and receive reimbursement according to the employer’s plan rules.
This may include reimbursement for:
- Medicare Part B premiums
- Medicare Part D premiums
- Medicare Advantage premiums
- Medicare Supplement premiums
- Certain out-of-pocket medical costs, depending on the plan design
However, this depends on the type of HRA, your employer’s rules, your Medicare enrollment, and federal compliance requirements.
That is why you should never assume. Always confirm with your employer’s benefits department, HR administrator, or reimbursement account provider.
Ask Your Employer This Question
“Do you offer an HRA, QSEHRA, ICHRA, retiree reimbursement account, or Medicare premium reimbursement benefit?”
Then call us and we can help you understand how it may fit with your Medicare choices.
Call Medicare Plan Assistance: 561-808-9410
Medicare Premium Reimbursement Checklist
If you are still working, recently retired, or covered under a spouse’s employer plan, use this checklist:
Ask Your Employer or HR Department:
- Do I have access to an HRA?
- Is it a QSEHRA, ICHRA, retiree HRA, or another reimbursement account?
- Can it reimburse Medicare Part B premiums?
- Can it reimburse Medicare Part D premiums?
- Can it reimburse Medicare Supplement or Medicare Advantage premiums?
- Do I need Medicare Parts A and B to participate?
- Do I need to submit proof of premium payment?
- Is reimbursement monthly, quarterly, or annual?
- Is there a deadline to submit claims?
- Does the account continue after I retire?
Do not wait until after you choose a Medicare plan to ask these questions. Your employer reimbursement rules can affect which Medicare option makes the most financial sense.
Other Ways to Lower Medicare Premiums
Employer reimbursement is not the only strategy. Depending on your income, coverage, and situation, there may be other programs that can help.
1. Apply for a Medicare Savings Program
Medicare Savings Programs are state-run programs that may help pay Medicare costs. Medicare.gov says these programs can help pay Part A and Part B premiums, and in some cases deductibles, coinsurance, and copayments.
For people who qualify, this can be one of the most powerful ways to lower Medicare costs because it may help with the Part B premium.
2. Apply for Extra Help With Prescription Drug Costs
Extra Help is a Medicare program that helps people with limited income and resources pay for Medicare drug coverage. In 2026, Medicare.gov says people with Extra Help may pay a $0 plan premium, $0 deductible, and limited copays for covered generic and brand-name drugs at participating pharmacies.
Social Security says you can apply for Extra Help before or after enrolling in Part D.
3. Review IRMAA If Your Income Dropped
If your Medicare premium is higher because of income from a prior tax year, you may be paying an IRMAA charge. If your income has since dropped because of a qualifying life-changing event, such as retirement, work reduction, divorce, or death of a spouse, you may be able to request a new decision through Social Security using Form SSA-44.
This can be especially important for people who had a one-time income spike, sold a business, took a large retirement distribution, or worked overtime before retiring.
4. Compare Medicare Advantage and Medicare Supplement Options
Some Medicare Advantage plans may have $0 monthly plan premiums, but you still need to review doctor networks, drug coverage, copays, maximum out-of-pocket limits, and extra benefits.
Medicare Supplement plans can offer more predictable medical costs, but they usually have separate monthly premiums and may require a separate Part D plan.
The lowest premium is not always the lowest total cost.
You May Be Paying More Than You Need To
Medicare costs can change every year. Your income, employer benefits, prescriptions, and plan options may also change.
Call Medicare Plan Assistance for a Medicare cost review.
Who Should Review Their Medicare Premiums?
You should review your Medicare costs if:
- You are still working after age 65
- Your spouse is still working
- You recently retired
- You have retiree health benefits
- You have an HRA or reimbursement account
- You pay a high Part B premium
- You pay an IRMAA surcharge
- Your income recently dropped
- Your prescriptions are expensive
- You are unsure if you qualify for Extra Help
- You are unsure if you qualify for a Medicare Savings Program
- You are choosing between employer coverage and Medicare
Even small changes can make a big difference over a year.
For example, if you can get help with a $202.90 monthly Part B premium, that may represent over $2,400 per year in potential premium relief, depending on the program or reimbursement arrangement.
Common Mistakes to Avoid
Mistake 1: Assuming Medicare Is Always Cheaper Than Employer Coverage
Sometimes Medicare is cheaper. Sometimes employer coverage is better. It depends on premiums, deductibles, networks, prescriptions, spouse coverage, and employer contributions.
Mistake 2: Not Asking About HRA Reimbursement
Many employees never ask whether their employer offers a QSEHRA, ICHRA, or retiree reimbursement account. That can leave money unused.
Mistake 3: Choosing a Plan Before Reviewing Prescriptions
Prescription costs can make one plan much more expensive than another, even when the monthly premium looks low.
Mistake 4: Ignoring IRMAA
If your Medicare premium increased because of past income, but your income has now dropped due to a qualifying life-changing event, it may be worth reviewing whether an IRMAA reduction request applies.
Mistake 5: Missing Help Programs
Medicare Savings Programs and Extra Help can reduce costs for people who qualify, but many seniors never apply because they assume they are not eligible.
Have Medicare and Still Working?
You may have more options than you realize.
Call Medicare Plan Assistance today and ask for a Medicare premium review.
Call Now: 561-808-9410
What Medicare Plan Assistance Can Help You Review
Medicare Plan Assistance can help you understand:
- Whether you should enroll in Medicare while still working
- How employer coverage may coordinate with Medicare
- Questions to ask your employer about HRA reimbursement
- Whether Medicare Advantage or Medicare Supplement makes sense
- Prescription drug coverage options
- Medicare Savings Program basics
- Extra Help basics
- IRMAA reduction questions
- How to avoid late enrollment penalties
- How to compare total annual costs, not just monthly premiums
We do not determine eligibility for employer reimbursement, Medicaid, Medicare Savings Programs, Extra Help, or IRMAA reductions. But we can help you understand the questions to ask and the Medicare choices available to you.
Final Advice: Do Not Leave Employer Benefits on the Table
If you or your spouse are still working, your employer benefits may be more valuable than you realize.
Before you assume Medicare is too expensive, check whether your employer offers:
- HRA
- QSEHRA
- ICHRA
- Retiree HRA
- Medicare premium reimbursement
- Spousal coverage
- Post-retirement health benefits
Then review your Medicare options carefully.
The best Medicare decision is not always the plan with the lowest premium. The best decision is the one that gives you the right coverage at the lowest realistic total cost.
Call Medicare Plan Assistance Today
If you want help lowering your Medicare costs, reviewing employer coverage, or understanding your Medicare options while still working, we are here to help.
Speak with a licensed Medicare advisor today.
Call Now: 561-808-9410
Frequently Asked Questions
Can my employer reimburse my Medicare Part B premium?
In some situations, yes. Certain employer reimbursement arrangements, such as an ICHRA or QSEHRA, may reimburse eligible healthcare premiums. The exact rules depend on the employer’s plan design and your eligibility. CMS guidance says ICHRA reimbursements may include premiums and cost sharing for Medicare when Medicare enrollment requirements are met.
What is an ICHRA?
An ICHRA is an Individual Coverage Health Reimbursement Arrangement. It allows employers to reimburse employees for eligible medical expenses, including certain premiums, when the employee has qualifying individual coverage. Healthcare.gov says individual coverage HRAs can reimburse medical expenses such as premiums, deductibles, and copayments.
What is a QSEHRA?
A QSEHRA is a Qualified Small Employer Health Reimbursement Arrangement. Healthcare.gov says certain small employers can use a QSEHRA to provide non-taxed reimbursement for certain healthcare expenses, such as health insurance premiums and coinsurance.
Should I sign up for Medicare if I am still working?
It depends on your employer coverage, employer size, spouse coverage, prescriptions, and costs. Medicare.gov says if you or your spouse are still working and have health insurance from a job, you may be able to wait to sign up for Medicare without a late enrollment penalty.
Can I lower my Medicare Part B premium?
Possibly. Some people may lower their effective Part B cost through an employer reimbursement arrangement, a Medicare Savings Program, or an IRMAA reduction request if their income dropped after a qualifying life-changing event.
Does Extra Help lower Medicare premiums?
Extra Help primarily helps with Medicare prescription drug coverage costs. Medicare.gov says Extra Help may reduce Part D plan premiums, deductibles, and prescription copays for people who qualify.
Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By calling 561-808-9410, you will be connected to a licensed insurance agent. Medicare Plan Assistance is not connected with or endorsed by the U.S. government, the federal Medicare program, CMS, Medicare, Medicaid, or the Social Security Administration. This article is for educational purposes only and does not provide tax, legal, financial, or employer benefits advice.