Advocacy in Action | Health Reimbursement Arrangement (HRA) Education
A member contacted Purple Card upset about a large amount of out-of-pocket money he owed the service provider for his emergency room visit. His Patient Advocate listened to the member and then reviewed the member’s emergency room claims and his coverage. She saw the member had selected a high deductible health plan and the claims for his emergency room visit were processed correctly. The allowed amounts under the insurance plan were applied to the member’s deductible, which is the member’s responsibility. So, the member did owe the service provider $1,500.
The Patient Advocate explained all of this to the member and then told him although he did owe the monies, she had some good news! After reviewing the member’s claims, she found the member had met enough of his in-network deductible to be eligible for his company’s Health Reimbursement Arrangement. She also proactively reviewed the member’s wife’s claims and she too was eligible for an HRA reimbursement. The member was not aware of the Health Reimbursement Arrangement (HRA) so the Patient Advocate explained to the member his employer offered the employees an HRA to help offset the additional deductible expense incurred under a high deductible health insurance plan. A Health Reimbursement Arrangement is commonly referred to as a Health Reimbursement Account. It is an IRS approved employer-funded, tax advantaged employer health benefit plan that is established to reimburse the employees for out-of-pocket medical expenses. In this instance, this member’s employer set up an HRA to reimburse the employee for a portion of the in-network deductible.
The member was elated to learn about the HRA and told his Patient Advocate he did not know his employer provided such a plan. The Patient Advocate took time to educate the member on how the HRA worked and assisted the member with obtaining the information needed from his on-line claims account to submit an HRA reimbursement request to the Third Party Administrator. The Patient Advocate also assisted the member with the submission of the information and tracked the progress. The member was very excited about his $2,805 HRA reimbursement!
At Brinson Benefits, we care about the patient’s best interest. We believe the patient should have an available healthcare navigator and advocate. Our Patient Advocates at The Purple Card® are highly trained to educate members about available benefit programs. They work hard to resolve issues with providers and insurers.
The Purple Card® is an independent health care advocacy and assistance service. Our Patient Advocates provide time and cost-saving services to resolve concerns about benefits programs. We not only assist our members, but we also educate them on ways to maximize health care coverage and other available benefit programs.
