GENERAL HRA FAQs

What is a Health Reimbursement Arrangement (HRA)?

The HRA is an employer-sponsored plan that can be used to reimburse a portion of you and your eligible family member’s out-of-pocket medical expenses, such as deductibles, coinsurance and/or copays. It is a financial reimbursement arrangement funded entirely by your employer that is paired with your medical plan.

What are the tax advantages of an HRA?

Reimbursements made from your employer through the HRA are not considered part of your income and are not taxed.

Who can contribute to an HRA?

Only your employer can contribute pre-tax or tax deductible dollars to your HRA

Who owns the HRA?

Your employer owns the arrangement and determines the scope of how it is set up and used – including the amount you and each employee will receive. The HRA is not portable. If you change jobs, the arrangement and any funds stay with the employer.

How can HRA funds be used?

Your employer may decide what types of medical expenses can be reimbursed through the HRA. Typically, reimbursable expenses can include deductibles, copays, coinsurance costs, prescription drugs, or other types of out-of-pocket costs. Check your Evidence of Coverage or summary plan description materials for details about your specific HRA.

What happens to unused funds in the HRA?

Most HRA funds “reset” at the beginning of the year, though some employers may allow the rollover of unused funds from year to year. Check your Evidence of Coverage or summary plan description materials for details about your specific HRA.

Who Do I Call For Questions About My HRA?

If you have questions about how an HRA from BlueCross BlueShield of Tennessee works, our Consumer Coaches are ready to help.  Just call 1-800-527-9206 or e-mail ConsumerCoach@BCBST.com for assistance.  If you already have a BlueCross BlueShield HRA, you can call customer service at 1-800-565-9140 for assistance

Can I go online to check my account activity?

Yes, log on to BlueAccess via BCBST.com to view your account balance, claims activity and your Personal Health Statement. 

What happens if the HRA amount requested for reimbursement is larger than my available account balance?

Reimbursement requests that exceed your account balance will be reimbursed up to the amount available in the account. Please remember that services must have been rendered before they will be reimbursed.

What if I have HRA dollars left over at the end of the year?

Check your HRA plan design. Your employer may allow your unused HRA funds to rollover into the next year, building up your HRA fund even more.

What if I run out of HRA dollars early in the year?

If you spend all your HRA dollars and still have an amount you need to meet toward your deductible, you will need to bridge that gap with money out of pocket. But once you’ve met the deductible, your health plan begins paying covered benefits with your responsibility limited to any copays or coinsurance that may apply.

What happens if I change jobs from my current employer?

If you leave the company or move to a different employer, your HRA does not travel with you. Since your employer funds the HRA, your employer owns any amount that remains after you leave. An exception may be if you elect COBRA continuation coverage. Check your plan details for more information.

If I have a Health Care Flexible Spending Account (FSA) and a Health Reimbursement Arrangement (HRA) through BlueCross BlueShield of Tennessee, which account will be used first?

The Health Care FSA and HRA, while separate accounts, provide reimbursement of qualified medical expenses as defined by your employer and the IRS (i.e., deductibles, coinsurance, prescription expenses). Should you have both accounts, expenses eligible under both plans will be reimbursed through the HRA first, then default to the FSA, The HRA will pay first, unless your employer specifies that the FSA will pay prior to the HRA. One reason to have the FSA pay first is because unused FSA money does not carry over.

How soon after enrollment does my HRA start to pay?

Your employer has the choice of allowing the HRA to pay before you meet any deductible, or it can be set up so that you have to meet a certain amount of out-of-pocket expense before the HRA begins to pay. Check your plan details for more information.

REIMBURSEMENT METHODS

What is Automatic Reimbursement?

Automatic reimbursement is an optional feature from your employer that submits the liability portion of your health care claim and automatically processes it against available HRA funds. If funds are available, a reimbursement is then sent to the health care provider along with any applicable medical coverage payment. Automatic reimbursement is one of the most important and desired features of our HRAs as it eliminates paper work for you.
If you have automatic reimbursement and use a network provider, your provider will submit a claim to BlueCross BlueShield of Tennessee. We will process the claim in accordance with your health plan design and pay the provider (on your behalf) any HRA amount that applies. You will receive an Explanation of Benefits form showing how payment was applied.  At the pharmacy, you will be required to pay up front and if there is HRA money available, the reimbursement will be sent directly to you.

How do I submit a paper (manual) request for reimbursement?

In most circumstances, you will not need to submit a manual request for reimbursement.  If the situation arises, requests can be made using an HRA Reimbursement Claim Form.

Simply complete and sign the claim form and attach one of the following:

• Your Explanation of Benefits from BlueCross BlueShield of Tennessee, or

• Receipts for prescriptions or qualified health-related

Completed reimbursement requests should be mailed or faxed to:

Mail:

BlueCross BlueShield of Tennessee
Claims Service Center
PO Box 180207-7207
Chattanooga, TN 37401-7207

Fax:

1-888-666-1221

What is an HRA debit card?The debit card with access to an HRA is a convenient option your employer may offer to you. The debit card allows you to access the funds in your account without having to complete and file forms. You can use the card whenever you incur an eligible expense at a qualified provider (such as an office visit copay or a prescription at a pharmacy). You can pay with your debit card instead of paying from your wallet.

What do I need to do to receive the debit card?

If your employer offers its employees the option of a debit card, you will automatically receive a debit card and will not need to complete additional paperwork.

How does the debit card work?

When you incur an eligible expense at a qualified provider (such as an office visit copay or a prescription at a pharmacy), you can pay with your debit card instead of paying from your wallet now and waiting for reimbursement later. You can use the debit card at merchants and health care providers that accept MasterCard® and are providers of qualified medical services. Use it for your plan’s approved expenses such as office visit copays, hospital deductibles, prescription copays, and other services that may be eligible under your health plan. It’s important to remember that the payment must be for eligible products or services that are reimbursable under your plan.

Do I still need to keep my receipts and documentation for prescriptions and office visits, plus the Explanation of Benefits that are sent to me?

Yes. Throughout the year, you should keep your original receipts and documentation for prescriptions and health-related expenses for all transactions (including debit card transactions), so you’ll have them if needed to verify a claim. The IRS requires that all transactions are validated, including the debit card transactions. In most cases involving debit card transactions, the electronic data we already have will be sufficient to accommodate this requirement. If we do not have the electronic data or if the transaction cannot be validated, we’ll contact you and you’ll be asked to provide documentation with receipts. Make sure you respond promptly to a request for receipts. Failure to do so can result in the expense being labeled as ‘ineligible,’ in which case; you would be obligated to reimburse your account. Failure to respond promptly can also result in deactivation of your debit card.

What happens if my receipt shows I accidentally used the debit card for an ineligible expense?

Your account can be used for eligible medical expenses only and you are responsible for reimbursing your account if the card is used either accidentally or intentionally for an ineligible expense. Any items you pick up at the pharmacy while you’re waiting for your prescription to be filled that are not qualified expenses (e.g., magazines, snacks, toothbrushes, etc.) cannot be paid for with your debit card. You must use a different method of payment for these types of purchases—don’t use your debit card. Your administrator will notify you if any ineligible purchases are made with your debit card, and your card may be deactivated until your account is reimbursed. Whether you are contacted or not, you will be required to pay back the money to your account.

Am I able to use my debit card to pay for over-the-counter medicines?

While you can use your debit card to pay for some over-the-counter medicines, please keep in mind that you may be asked to submit receipts and documentation for these purchases. The Internal Revenue Service (IRS) has changed the law to cover some over-the-counter drugs, including antacids, allergy medicines, pain relievers and cold medicines. For the exact list of what is covered, please sign into BlueAccess and see the list of qualified medical expenses. 

What if I owe my provider more than I have available in my account?

The card will be declined if ‘swiped’ for more than your available balance. Simply ask your provider to ‘swipe’ the card for your available balance and pay the difference out-of-pocket. Another option would be to pay the amount yourself and submit a reimbursement request with your receipt to the address provided on the claim reimbursement form.

What if I don’t owe anything when I’m at my doctor’s office, but I get a bill later?

You can still use the card to pay the bill by writing your debit card number on the invoice and mailing it in, or by providing the card information over the phone to the physician’s office.

Are all of my family members able to use the debit card to pay for their health care expenses?

You are provided a debit card with your name personalized on it. Only the individual whose name is on the card can use the card when making a health care related purchase, but the purchase can be for anyone covered under your plan.

Since it’s a MasterCard®, can I use my debit card like a traditional credit card?

The card only allows processing of health care expenses reimbursed through your program and only accepts transactions using providers of authorized services.

Am I able to put more money into my account once I use all the funds available through my debit card?

No. Once the account is depleted, you won’t be able to use the debit card and you’ll be responsible for paying for any additional out-of-pocket costs.

What happens if my debit card is lost or stolen?

If your card is lost or stolen, report it as soon as possible by contacting us by phone at 1-800-565-9140. A replacement card will be sent to you.

Am I still able to access the funds in my account without the debit card?

Yes, if your provider or merchant does not accept MasterCard® or you choose not to use your debit card, simply pay for your expenses and submit a request for reimbursement claim form along with the receipt for the eligible expense(s) to the address provided.

What do I do if I have used my debit card to pay for expenses that are later reimbursed by my insurance?

It is always better to submit a manual reimbursement request when a medical service is subject to a deductible or coinsurance. If you have mistakenly used your debit card to pay for an expense that is later reimbursed by your insurance, IRS regulations require you to pay the amount back to your account.

Where can I find the “Terms and Conditions” for use of the debit card?

The “Terms and Conditions” for use of the debit card are outlined on the Cardholder Agreement that accompanies your debit card. By signing and using the card you agree to use the card in conjunction with those rules.

What happens if my transaction is denied?

After the debit card is ‘swiped’, the system verifies that adequate funds are available in your account and that the expense is from a qualified merchant. If these checks are positive, the funds are then deducted automatically from your account. If these checks are negative, the transaction is denied. If the transaction is denied, then other methods of payment must be used.

What happens to my account(s) if I terminate employment?

You will have a limited period of time to submit additional requests for reimbursement of qualified medical expenses incurred while you were employed, and, at the end of that period, the account balance will be forfeited.