Insurance premiums. You can’t treat insurance premiums as qualified medical expenses unless the premiums
are for any of the following.
4. Medicare and other health care coverage if you were 65 or older (other than premiums for a Medicare supplemental policy, such as Medigap
HOWEVER>
For 4 above, if you, the account beneficiary, aren’t 65 or older, Medicare premiums for coverage of your spouse or a dependent (who is 65 or older) aren’t generally qualified medical expenses.
so until you turn 65 any medicare premiums you pay for your spouse would be subject to regular income taxes + a 20% penalty.
based on your only be able to cover his medicare costs once you turn 65, any medicare premiums before that time would not be a qualified expense.
