Medicare + ICHRA Overview
How do Medicare and ICHRA (CHOICE) work together for me and my family?
Medicare is your health insurance. ICHRA (CHOICE) is the employer-funded benefit that helps pay for your eligible Medicare coverage.
Quick answer
Medicare and ICHRA (CHOICE) do different jobs. Medicare is your health coverage. ICHRA (CHOICE) is the employer contribution that helps pay eligible Medicare premiums after you enroll in Parts A and B. The Medicare-eligible employee must leave the prior individual or group health plan as their own coverage and use Medicare instead. Family members may have different coverage paths.
Medicare is the coverage; ICHRA (CHOICE) is the funding
Think of the transition in two layers.
Layer one: Medicare coverage. You enroll in Parts A and B. Then you choose how to complete your Medicare coverage: Original Medicare with Medigap and Part D, or a Medicare Advantage plan. That coverage is what pays for your health care.
Layer two: ICHRA (CHOICE). Your employer funds a contribution for the Medicare path. Once your coverage is active, the contribution is connected to eligible premiums through the approved benefitbay workflow. In the current benefitbay ICHRA (CHOICE) experience, applicable Medicare plan premiums are set up to be paid directly from your benefitbay ARC account rather than requiring you to pay first and wait to be reimbursed.
The order cannot be reversed. ICHRA (CHOICE) does not enroll you in Medicare. It becomes usable after you have the required Medicare foundation.
What ICHRA (CHOICE) supports
After Parts A and B are active, ICHRA (CHOICE) can be used for eligible Medicare premiums based on the employer plan and the coverage you select. That can include the premiums connected to Medicare Advantage, standalone Part D, or Medigap coverage. Part A and Part B premium handling is also part of the payment setup, including the special process for people whose Part A premiums are withheld from Social Security.
The benefitbay Medicare Team will confirm the correct setup before your coverage begins. Do not make a payment from a personal bank account or set up an alternative payment method without confirming with a benefitbay Medicare advisor first.
What changes for your family
Your Medicare transition does not force every household member into Medicare. It does create a clear household planning task:
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You, the Medicare-eligible employee: Enroll in Parts A and B and leave the prior group or individual plan as your own coverage.
- A spouse who is also Medicare-eligible: Makes their own Parts A and B and coverage decision. Medicare Supplement (Medigap) policies are individual, so each spouse who wants a supplement needs a separate policy.
- A spouse or child who is not Medicare-eligible: Remains on the coverage path available to them.
The ICHRA (CHOICE) terms for dependents come from the employer plan. HR or benefitbay can confirm who is eligible and how the ICHRA (CHOICE) contribution applies. The benefitbay Medicare Team can help you separate the employee’s Medicare transition from the rest of the household’s coverage needs.
The bottom line
For the employee entering this benefit, Medicare is not an add-on to the prior plan. It is the new coverage foundation. ICHRA (CHOICE) follows Medicare and helps pay eligible premiums through the benefitbay process.
