How HRAs work

How your health reimbursement arrangement (HRA) pays for your care

Setting up your HRA

Your employer first chooses a health plan.

• It can be self-funded (where your employer pays your medical costs) or fully funded (your employer only pays premiums, Priority Health pays all your medical costs).
• It can be an HMO, a POS, or a PPO plan.

Your employer sets up a health reimbursement arrangement (HRA) of any dollar amount to help you cover the deductible, or the deductible and your coinsurance, on the plan.

Paying for care

• Your Priority Health medical plan entitles you to a discount at health care providers in your plan's network. You need to know what plan you have - HMO, POS, PPO, etc. Then you can use the online Find a Doctor directory to find doctors, specialists, hospitals and other providers in your plan's network.
• You don't have to meet your deductible before your plan will pay for preventive care like immunizations, mammograms and routine physicals. Just go to the doctor and pay your plan's office visit copay. Your copay won't apply to your deductible.
• You will have to "meet your deductible" before your medical plan begins to pay for "qualified health care expenses," which are medical costs that are covered by the plan. "Meeting your deductible" means you pay 100% of your medical costs up to the dollar amount of your deductible. If you have a $2,500 deductible, you have to pay $2,500 before your health plan begins to pay.
  See a list of qualified health care expenses.
• You'll use your own money plus the money in the HRA to meet your deductible.
  Depending on how your employer sets up your HRA:
• Sometimes the HRA pays first. The HRA pays for your medical costs until it runs out, then you have to pay for your health care until the amount you pay meets the amount of your deductible. Then your medical plan begins to pay for your medical costs.
• Sometimes you pay first. You pay your medical costs up to a certain point, then your employer's HRA kicks in. Then when your deductible is met, your medical plan begins to pay for your medical costs.
• Sometimes you split the payments. Your HRA pays a certain percent, and you pay the rest (50%/50%, or 40%/60% for example) of your medical costs, until your HRA money runs out. Then you pay 100% of your medical costs until you meet your deductible. Then your medical plan begins to pay for your medical costs.

Direct payments mean less paperwork

You don't have to file claim forms. When Priority Health gets a claim (a bill) telling us that you received some health care services, we automatically check your HRA balance to see if HRA money is available. You don't have to file paperwork, and your doctors and other health care providers are paid promptly.

• If money is available in your HRA, we process claims automatically to pay them. The payment will cover part or all of the claim.
• You'll receive a simple statement each time you receive medical services, showing your deductible and HRA balances and what your share of any cost may be.

Tracking your HRA balance

Log in to your personal Priority Health account online on this website to see the balance available in your HRA account, your deductible balance, claims history, and much more.

Register to view your Priority Health account online now. All you need is your contract number from your ID card.

Already have an online account? Log in now.