Page 9 - PageGroup | 2022 Benefits Guide | Temp Employees
P. 9
Amy has a family of four and has $1,000 in her HRA
Date of Service
Billed Charges
Amy Pays
Aetna Pays
Explanation Of Payouts*
IN ACTION
Her son goes to the hospital for pneumonia 1/15/20221 1 Matt: $800
$800 $0
$605 $1,395
$1,425 $1,575
Amy and Matt are involved in a car accident 5/15/2022
1 The $800 hospital bill is paid directly from Amy's HRA.
2/3 Matt: $2,000
4/5 Amy: $3,000
2 There is a $200 remaining balance in Amy's HRA. This is used to pay a portion of Matt's hospital bill as a result of the accident.
3 Amy pays another $250 out of pocket which now satisfies Matt's annual individual deductible of $1,250. Amy is now responsible and must pay 10% coinsurance of the remaining balance of $1,550 or $155. Amy's total out of pocket expense for Matt's hospital bill is $605.
4 Amy pays $1,250 out of pocket for her hospital bill which now satisfies the family annual deductible of $2,500.
5 Amy is now responsible and must pay 10% coinsurance of the remaining balance of $1,750 or $175. Amy's total out of pocket expense for her hospital bill is $1,425.
*Above examples reference In-Network care only.
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