Section 105 Medical Reimbursements

September 12, 2025

Are you looking for a flexible, tax-efficient way to pay medical expenses either for yourself or your employees? A Section 105 Medical Reimbursement Plan may be the solution. 

They are reimbursements by an employer of amounts paid by an employee for medicines, drugs purchased by the employee with or without a physician’s prescription excludable from gross income under Section 105(b) of the Internal Revenue Code. 

Reimbursements by an employer of amounts paid by an employee for medicines and drugs purchased by the employee without a physician’s prescription are excludable from gross income under § 105(b). However, amounts paid by an employee for dietary supplements that are merely beneficial to the general health of the employee or the employee’s spouse or dependents, are not reimbursable or excludable from gross income under § 105(b). 

This IRS-approved benefit allows businesses to reimburse employees for medical expenses, including health insurance premiums, with significant tax advantages. 

What’s the benefit? 

  • Reimbursements are 100% deductible to the business 
  • Benefits are tax-free for the employee 
  • Covers insurance premiums, co-pays, prescriptions, dental, and more 
  • Customizable for small business needs 

Who can use it? 

  • C Corporations: Owners and employees can fully participate 
  • S Corporations: Owners owning >2% cannot receive tax-free reimbursements 
  • Sole Props/Partnerships: Use the spouse-as-employee strategy to cover the family 

Bonus Tip: Hire your spouse legitimately and offer a Section 105 plan that covers your household—creating a legal, tax-efficient way to deduct family medical costs. 

 Key Requirements 

  • Must have a written plan document 
  • Only the employer can fund the plan 
  • Expenses must be substantiated with proof 
  • Follow IRS compliance and non-discrimination rules 

 Let’s Talk Strategy! 
Our team at Campbell and Company can help you determine if a Section 105 Plan is right for your business, draft the required documentation, and walk you through setup and compliance. 

Monica Haberlin, EA 

Partner