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While the Choice Fund HRA Plan may similar to the other plans in some ways, there are some very important differences and advantages over an HMO.
- Provider Choice. Unlike an HMO, the Choice Fund HRA Plan allows you to go to any doctor you choose, except for preventive care - preventive care is only covered in-network.
- No PCPs or Referrals. You do not have to designate a primary care physician (PCP), and you do not need a referral to see a specialist with the Choice Fund HRA Plan.
- Network. In an HMO, you must see a network doctor. Choice Fund also offers a network, and you will save by using a network doctor or hospital. But there is also out-of-network coverage if you wish to see a doctor that doesn't participate.
- No Copays. There are no copays with the Choice Fund HRA Plan. As long as you have a balance on the HRA available, you pay nothing out-of-pocket.
- Health Reimbursement Account Feature (HRA). The HRA, which UC funds, automatically pays first for 100% of eligible medical and pharmacy expenses until the balance is exhausted. If you use up your HRA dollars, the traditional health plan features begin.
Your HRA:
employee $1,000
employee + adult $1,500
employee + child(ren) $1,500
family $2,000
- Unused HRA Balances Roll Over. Any unused balances left over in your HRA at the end of the plan year carries over to the next year - reducing the amount you may have to pay for future health care expenses.
- Deductible Isn't Upfront. The deductible works differently than with an HMO. When you use the plan, payment for services is deducted from the HRA. If you exhaust your HRA, then you pay the remaining share of the deductible. If you don't use all of your HRA, the deductible doesn't come into play and you pay nothing.
- Tools and Resources. Choice Fund includes many tools and resources, such as a discount program for items not covered by your plan such as Weight Watchers and Lasik eye surgery, a 24-hour nurse line, a personal website to track your account, and CIGNA's specially trained Customer Service representatives.
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