Health coverage plus a fund
An Aetna HealthFund® Health Reimbursement Arrangement (HRA)* gives you access to quality care. And it helps you stretch your health care dollars.
Our HRA combines an Aetna health insurance or benefits plan with a fund paid for by your employer. This fund helps you pay eligible out-of-pocket health care costs.
HRA advantages
Convenience. Your employer sets up the fund for you. No claims forms are needed if you visit doctors and other health care providers in our national network. Eligible health care expenses are automatically paid from the fund.
Tax-free benefits. The fund doesn’t count as taxable income. That means you cover some health care costs with tax-free dollars.
Staying power. If you don’t use the entire fund during the year, it’s not a problem. The balance usually rolls over to next year’s fund. (But if you change employers or health plans, you can’t take it with you.)
How it works
Your HRA has three parts:
1. A fund
Your employer sets aside an amount for the HRA — the fund —each year. Use this fund to cover health care costs that are eligible under your health plan.
These may include:
- Deductibles
- Coinsurance
- Prescription drugs
Expenses are automatically paid from the fund.
2. Your deductible
You pay this amount each year before your health plan begins to pay toward your covered expenses. You can use the fund to pay your deductible.
Say you have a $2,000 deductible and $1,000 in the fund. Use the fund to pay for $1,000 in out-of-pocket costs. Then, pay $1,000 of your own money to reach the full $2,000 deductible.
3. Your health plan
Once the deductible is paid, your health plan shares the cost of eligible expenses.
Generally, you pay coinsurance. This can be paid for by your HRA as long as there’s a balance in the fund.
Does your employer offer an RRA?
A retirement reimbursement arrangement, or RRA, is a safety net for retirement. It gives you employer-funded support for health care expenses.
Here’s how an RRA works:
- Your employer sets up and pays into the fund.
- You use the fund to get reimbursed for qualified health care costs that you have paid. These may include premiums and other out-of-pocket costs that have been determined by your employer.***
- Any unused balance in the RRA rolls over to the next year.
Check with your employer for the details.
Make it work for you
Whether you have an HRA or RRA, you’ll want to stretch those fund dollars. Here’s how:
- Keep track of your deductible and fund balances. Members can log in to view their accounts.
- Stay in network. Doctors, hospitals and other health care providers in our network have a contract to provide reduced rates to our members.
- Know before you go. See what you’ll pay for certain types of care, based on your actual plan, using our Member Payment Estimator.** It lets you compare estimated costs for up to 10 doctors or health care facilities at a time. Members can log in to their secure account to use the tool.
*HRAs are currently not available to HMO members in Illinois or to Small Group customers in Florida.
**Estimated costs not available in all markets. The tool gives you an estimate of what you would owe for a particular service based on your plan at that very point in time. Actual costs may differ from the estimate if, for example, claims for other services are processed after you get your estimate but before the claim for this service is submitted. Or, if the doctor or facility performs a different service at the time of your visit. HMO members can only look up estimated costs for doctor and outpatient facility services.
***Qualified expenses determined by the employer according to IRS guidelines can be reimbursed by an RRA. These expenses may include health coverage premiums and most health-related expenses.
