With a split HRA, you pay a portion and your HRA pays a portion. You might pay 50 percent while your HRA pays 50 percent. Or, you might pay 25 percent and your HRA would pay 75 percent.
Let's look at a 50-50 split HRA.
Mary has a health plan with a $2,500 deductible, 50 percent coinsurance and an HRA with $1,000. Her employer chose a 50-50 plan and only her deductible is eligible for coverage by her HRA.
- Mary goes to the doctor for a cough she can’t get rid of. There are a couple of infections going around, so her doctor orders a chest X-ray.
- The X-ray costs $150. Since Mary has a 50-50 HRA, she pays $75 and the funds in her HRA can pay $75. The full $150 counts toward her deductible.
- After her appointment, there’s $2,350 left before she reaches her deductible and she has $925 left to spend in her HRA.
Her copay for the doctor visit is $20, but her HRA won’t cover that. She has to pay that copay out of pocket.