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With an HRA plan, you get a reimbursement account that is funded by diversified to help pay for expenses as you work toward your deductible.  The reimbursement account is first dollar.  This means, that all expenses are paid by the reimbursement account first.  Once the money in the reimbursement account is depleted, then you are responsible for paying the costs of services out of pocket at 100% until you meet your deductible.  Once your deductible is met, you have a 20% co-insurance up to your annual out of pocket maximum.

Let’s take look at how it works IRL.  You or a covered family member visit the doctor for an illness or injury and the cost of that visit is $150.  With an HRA plan, you do not pay at time of service. Rather, the doctor bills your insurance the cost of the visit.  Aetna will look at your account and see that you have an HRA balance of $1,500 for example.  The full cost of the visit, $150 will be paid for with your HRA fund.  You do not pay for services incurred out of pocket until your HRA fund is depleted. Then you pay out of pocket for the cost of services until your deductible is met.    

Highlights

• Low premiums
• Employer funded  contributions
• Rollover HRA funds up to your out of pocket max

With a PPO plan you pay a co-pay at the time of service and the costs of services until you meet your deductible.  Once the deductible is met, you have a 20% co-insurance up to your annual out of pocket maximum. 

Highlights

• Low deductible
• No employer contributions
• No roll over funds