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2019 PCA and HSA Plan Option Comparison

Here is a comparison of the features of the PCA and HSA Medical Plan Options:

2019 PCA AND HSA PLAN OPTION COMPARISON: actives

OPTION FEATURES

PCA PLAN OPTION

HSA PLAN OPTION

Deductible1

Medical Only

Combined Medical and Rx

  • You Only2

$1,500

$1,350

  • You + One dependent2

$3,000 ($1,500 per person)

$2,700

  • You + Two or more dependents2


$4,500 ($1,500 per person)


$2,700

Coinsurance
(In-Network)

Medical Only

You pay 10% after deductible up to $2,000/person maximum or $4,000 for family maximum

 

Combined Medical and Rx

You pay 10% after deductible up to maximum of $3,650 for You Only or $3,850 for all other coverage tiers

 

Coinsurance
(Out-of-Network)

You pay 30% after deductible, in addition to charges above the usual and customary limits.

You pay 30% after deductible, in addition to charges above the usual and customary limits.

Out-of-Pocket Maximum

Medical Only

$3,500/person or
$8,500 for family

Rx Only

$3,350/person or
$5,200 for family

Combined Medical and Rx

$5,000 for You Only or $6,550 for all other coverage tiers

 

Out-of-Pocket Maximum
(Out-of-Network)

None

None

Funded by

USAA

You; through payroll deduction

Maximum Annual Contribution

   
  • You Only

$750 (funded by USAA)

$3,500

  • You + One dependent

$1,500 (funded by USAA)

$7,000

  • You + Two or more dependents

$2,250 (funded by USAA)

$7,000

  • Catch-Up (over 55)

Not applicable

$1,000

Roll Over

Yes; no maximum

Yes; no maximum

Using Funds for Eligible Expenses

Debit card or file reimbursement

Debit card or file reimbursement

Portable if you leave USAA

No

Yes

PCA dollars can be used as part of the HSA plan to help you pay out-of-pocket medical and prescription drug costs in excess of $1,350 for individuals and $2,700 for families, such as your deductible and coinsurance once your deductible has been met.

1 Participants are responsible for 100 percent of cost until the deductible is met.

2 The PCA Plan Option has separate individual and family deductibles. Individual coverage includes a deductible of $1,500. Coverage for Individual + One has an individual deductible of $1,500 and a family deductible of $3,000. Coverage for Individual + Two has an individual deductible of $1,500 and a family deductible of $4,500. Note: No one family member may contribute more than the individual deductible of $1,500 toward the family deductible. The applicable deductible must be met before the plan pays for healthcare services (except preventative care benefits).

You can also access the printable version of the Plan Comparison Chart.

 

 

Questions about your benefits? Visit the Contact Us page for contact information on each vendor.