ICHRA eligible expenses 2025 | Vitable

ICHRA

Health Benefits

Table of Contents

What is an Individual Coverage HRA? ICHRA-Eligible Plans Include: What Medical Expenses Are Eligible for Reimbursement Under an ICHRA? ICHRA Eligible Expenses: What’s Covered What’s Not Covered? ICHRA Exclusions to Know Over-the-Counter Items That Don’t Qualify Medical Expenses That Aren’t Deductible Vitable ICHRA: Better Benefits Start Here

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Looking into offering an Individual Coverage Health Reimbursement Arrangement (ICHRA) in 2025? Or already enrolled and want to get the most from your plan? Let’s break down what’s covered, what’s not, and how Vitable helps make it easier than ever to access care that actually works for you and your employees.

While Individual Coverage HRAs (ICHRAs) are still relatively new, they’re quickly becoming a favorite among forward-thinking employers—and for good reason. They're flexible, user-friendly, and offer big tax advantages for everyone involved.

In this article, we’ll help you understand which medical expenses are eligible for reimbursement under an ICHRA and what’s not, so you and your employees can take full advantage of your health reimbursement arrangement (HRA) plan.

What is an Individual Coverage HRA?

An Individual Coverage HRA (ICHRA) is a health benefit that allows employers to reimburse employees for health insurance, rather than selecting and managing a group plan for them. An ICHRA gives employers the power to customize their offering by deciding what types of expenses they want to reimburse, including:

Whether you choose to cover just premiums or premiums and a mix of medical expenses, the key advantage remains the same: reimbursements are completely tax-free for both the employer and the employee. That means no income tax, no payroll tax, and no employer tax liability.

ICHRA-Eligible Plans Include:

Employees must be enrolled in a qualifying individual health plan to participate in an ICHRA.

These can include:

What Medical Expenses Are Eligible for Reimbursement Under an ICHRA?

The IRS has outlined all ICHRA-eligible medical expenses, also referred to as “qualified medical expenses,” in Publication 502. Eligible expenses for ICHRA are the same as those for Health Savings Accounts (HSAs). That list will be your go-to reference for what’s covered: routine doctor visits, prescription medications, diagnostic tests, mental health care, dental work, and even durable medical equipment like crutches or hearing aids.

Employers can decide whether to cover all eligible medical expenses or just specific categories, such as prescriptions or preventive care. The key is consistency: whatever you choose must be offered fairly across your team. One of the major advantages of ICHRA is the built-in flexibility. By offering reimbursements for such a broad range of medical costs, ICHRAs give employees more control over how they use their benefits, and give employers the ability to tailor offerings in a way that aligns with their bottom line.

ICHRA Eligible Expenses: What’s Covered

One of the best parts of an ICHRA is just how wide the coverage can be. When employers choose to reimburse for qualified medical expenses, employees can use their benefits toward hundreds of healthcare costs—not just premiums or co-pays. From preventive care to mental health to medical devices, the eligible list is long and incredibly useful.

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Below are just some of the many medical expenses that can be reimbursed tax-free under an ICHRA when included in the plan design:

Expecting mothers can also receive reimbursements for prenatal massage and chiropractic care during their pregnancy.

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What’s Not Covered? ICHRA Exclusions to Know

While ICHRAs cover a wide range of expenses, not everything qualifies. Some products and services are considered general health or lifestyle-related, and therefore aren't reimbursable—even if they support your overall wellness.

Here’s a quick look at what’s not eligible for ICHRA reimbursement:

Over-the-Counter Items That Don’t Qualify

Medical Expenses That Aren’t Deductible

Vitable ICHRA: Better Benefits Start Here

At Vitable, we’re setting a new standard for health benefits. We’re a health benefits platform designed to make healthcare better for everyday workers. With Vitable, employers can offer a more flexible, affordable, and accessible experience for their teams, without the complexity of traditional insurance processes.

We offer a suite of benefit options, including ICHRA plans, but unlike traditional ICHRA plans, every ICHRA through Vitable includes our enhanced Primary Care membership. That means your employees get direct access to everyday care—like primary care visits, urgent visits, preventive screenings, and chronic condition support—without having to use any of their ICHRA reimbursement allowance. By covering essential, everyday care through Vitable’s Primary Care membership, your employees’ reimbursement dollars go further, helping them pay for other eligible medical expenses like prescriptions, dental care, or specialty visits.

It’s a better healthcare experience for employees and a smarter, more sustainable solution for employers.

Whether you’re just starting to explore ICHRA or ready to make the switch, we’re here to help. Our team can walk you through how ICHRAs work, what expenses are eligible, and how Vitable can help you create a benefits plan that fits your budget and supports your workforce.

Ready to offer better benefits? Get started today!

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Download 2025 Employer Guide to ICHRA

Vitable’s ICHRA Guide gives employers a clear, step-by-step resource for building smarter, ACA-compliant benefits.

This guide explains how ICHRAs work, who qualifies, and how Vitable simplifies setup, onboarding, reimbursements, and compliance — while giving employees more flexibility, control, and care.

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Download Vitable’s 2025 Broker’s Guide to ICHRA

The Broker Guide to ICHRAs is a comprehensive resource that helps brokers understand, sell, and manage Individual Coverage HRAs with confidence.

This guide covers everything from compliance and class design to administration flows, case studies, and how Vitable streamlines quoting, enrollments, and reimbursements for brokers, employers, and employees.

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