When your HRA pays first, the funds in your account cover 100 percent of your eligible medical services as soon as you need it.
Sean has a $2,500 deductible with 50 percent coinsurance and an HRA with $1,000.
- He has asthma and visits his doctor every month for breathing treatments that cost $500 each.
- Sean's HRA funds will cover the cost of his first two treatments, since they each cost $500 and his HRA has $1,000. Sean won't pay out of pocket until his HRA funds run out.
- Sean’s copay is $30 for each office visit. He has to pay those out of pocket.
- Between the cost of his breathing treatments covered by his HRA and his out-of-pocket costs, Sean reaches his $2,500 deductible.
Those breathing treatments are subject to 50 percent coinsurance now that he’s reached his deductible. Sean pays that until he meets his out-of-pocket maximum.