Consumer-Directed Health Plans and Health Expense Funds

What the plans provide:

Consumer-directed health plans (or CDHPs) are not that much different from the health plans you already know. They give you:

• Peace of mind, knowing you have health coverage.
• A deductible that often comes with a health insurance or health benefits plan. Your deductible is the amount you pay out of your own pocket before a medical plan begins to pay. While your deductible is higher than traditional health plans, the premium you pay may be lower.
• A special fund (or account) to help you pay for certain health care expenses.
• Preventive care covered at 100%.

Tips to help manage a plan:

With a CDHP, you are in charge. So use these smart tips to stay on top of your plan – and its costs.

• Manage expenses by keeping track of your deductible and fund balances.  If you are an Aetna member, register for access to your secure member website.
• Visit doctors in your plan’s network and order prescription drugs by mail. These steps should save money.  For more about health benefits, including ways to save money, visit Plan for Your Health. You can also use our Cost of Care tools to help manage your expenses.

Two other ways to save: 

Health Reimbursement Arrangement (HRA)* 

Here’s a way your employer can help you take care of your health. With an HRA,  your employer sets up a fund to help you pay for certain health care expenses.  An HRA gives you these advantages:

• Planning for the Future – Unused HRA funds may carry over to the next year, as long as you stay in the plan. This way, you can build up your fund for when you really need it.
• Flexibility – Your fund gives you a head start on paying for health care. And with preventive care covered at 100 percent, you can keep more in your fund. After you’ve used up your fund, you’ll have a health plan which pays for a portion of some expenses. Your health plan begins to pay after you meet a deductible amount.
• Savings – Once your health plan starts paying its share, you’ll pay a smaller portion of these costs from your own pocket.

Please note: Your employer may limit the money you can carry over. Also, HRA funds can be used only for certain health care expenses (please see your plan documents for more details).

*HRAs are currently not available for Small Group in Florida. HRAs are currently not available to HMO members in Illinois.

Health Savings Account (HSA)**

These days, you’re watching every health care dollar. And we can help you see that they don’t get lost. An HSA is a tax-advantaged savings account that lets you pay for current health care expenses. Or, you can save for future expenses. To be eligible for an HSA, you must be covered by a consumer directed health plan. And you must not be eligible for coverage under any other health plan. Here are some ways to make the most of your HSA:

• Tax Advantages – With payroll deduction, you can put money into your account before taxes. This may lower your taxable income.
• Carry-Over – HSA balances carry over from one year to the next. That’s true even if you change jobs or health plans. Once you set up an HSA, it’s all yours!
• You can use money from an HSA to pay for certain expenses (defined by the IRS). Get a list of these expenses from your secure member website, or go to IRS Publication 502, at www.irs.gov. 

**HSAs are currently not available to HMO members in Illinois