Manage Your HRA Appropriately When You Have Two Commercial Insurances
If you have two commercial medical insurances along with a health reimbursement arrangement, both insurance carriers need to process the claim before you can submit any remaining balances to your HRA.
If you have an integrated HRA and multiple insurances, your medical claims will not automatically pay from your HRA.
Steps to Take To Ensure Timely Process of Medical Claims
- Present both insurance cards at the time of service and advise your provider’s office which insurance is primary and secondary.
- If you receive a bill from the provider after the primary insurance carrier has processed the claim, you should contact the provider’s office to instruct them to bill your secondary insurance, or you can write the secondary insurance information on the back of the bill and return to the billing address.
- If there is any patient responsibility after the secondary insurance has processed the claim, submit the secondary insurance explanation of benefits (EOB) along with an HRA claim form to the health funding department at CDPHP.
- HRA dollars for the portion not covered by the primary and secondary insurance will be processed and sent directly to you, provided the expense is considered an eligible expense based on IRS guidelines.
We encourage providers to bill CDPHP first on deductible plans, but if a provider requires that you pay up front, the provider should continue to bill CDPHP for the services. If CDPHP is your primary insurance carrier, once you receive your EOB from CDPHP, any balances should be submitted to your secondary insurance. Finally, if there are any balances after your secondary insurance processes your claim, you may submit the secondary insurance EOB with an HRA claim form.
If your provider repeatedly bills you a balance without submitting your claim to both your primary and secondary insurance carriers, please contact the health funding department for assistance at 1 (518) 641-3770 or 1 (877) 793-3960, available 8 a.m. to 8 p.m. Monday through Friday.
Claims for Prescription Drugs
CDPHP and Caremark do not coordinate benefits on prescription drugs. Therefore, you may use your HRA to pay for your prescriptions if it is an eligible expense on your plan and has not been paid for by a secondary insurance.