High Deductible Health Plan with an HSA or HRA

High Deductible Health Plan (HDHP)

An HDHP is a health insurance plan designed to save on insurance premium costs, with a minimum deductible of $1,200 (self-only coverage) or $2,400 (family coverage). The annual out-of-pocket, including deductibles and co-insurance, does not exceed $5,000 (self-only coverage) or $10,000 (family coverage).

In HDHPs, the pharmacy costs are included in the annual deductible and out-of-pocket costs. Eventhough you are responsible for the entire cost of the prescription until the deductible is met, you still receive the PHP network discount by using your PHP Rx card. Once your deductible is met, prescription costs would be covered at your plan's co-insurance level. Flat dollar prescription copays would not apply to these plans.

You may also have one of the following products that would provide reimbursement for qualified out-of-pocket pharmacy expenses:

Health Savings Account (HSA) - An HSA allows employees to pay for current healthcare expenses (such as eligible presciptions outlined by your plan) and save for future qualified medical and retiree healthcare expenses on a tax-free basis. An individual must be covered by a high deductible health plan to be eligible for an HSA.

Health Reimbursement Arrangement (HRA) - An HRA may be offered by your employer to help with the cost of your medical needs. An HRA allows your employer to reimburse you a specified amount for the qualified medical expenses (such as eligible prescriptions outlined by your plan) incurred by you and your dependents. It works in conjunction with your health plan to offset deductibles with reimbursements your employer makes to you. With an HRA, you benefit from health insurance protection, plus extra dollars you receive from your employer to help manage your healthcare expenses.