In this plan setup you pay an HRA deductible. After that, you and your HRA split your health care costs. You could pay 25 percent while your HRA pays 75 percent. Or, you might pay 50 percent and your HRA would pay 50 percent.
Bill has a $6,000 plan deductible, an HRA funded with $2,000 and an HRA deductible of $1,000. After Bill meets his HRA deductible, he'll split the costs 50/50 with his HRA. After his HRA funds run out, he'll pay out of pocket until he meets his plan's deductible.
- Bill is admitted to the hospital. Since he has to meet his HRA deductible before his funds are available, he pays $1,000 out of pocket. Now he has $5,000 left before he meets his plan's deductible.
- Since Bill met his HRA deductible, the funds are available. With a 50/50 split, he pays 50 percent of his costs out of pocket and his HRA covers the other 50 percent. In this case, since his HRA has $2,000, he would pay $2,000 and so would his HRA.
- Between his $1,000 HRA deductible, the $2,000 his HRA covered and the $2,000 he paid out of pocket, Bill has reached $5,000 of his $6,000 deductible. He has to pay the remaining $1,000 out of pocket to reach his plan's deductible.
- After that, Bill is responsible for his coinsurance until he meets his out-of-pocket maximum.