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2020 PCA and HSA Plan Option Comparison

2020 PCA and HSA Plan Option Comparison

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

PCA AND HSA PLAN OPTION COMPARISON

OPTION FEATURES

PCA PLAN OPTION

HSA PLAN OPTION

Deductible1

Medical Only

Combined Medical and Rx

  • You Only

$1,500

$1,400

  • You + One dependent2

$3,000

$2,800

  • You + Two or more dependents2


$4,500


$2,800

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 $3,600 for You Only or $3,750 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

Spending Account Contributions Funded by

USAA

You; through payroll deduction

Spending Account Contributions

 

 

  • You Only

$750 (funded by USAA)

$3,550

  • You + One dependent

$1,500 (funded by USAA)

$7,100

  • You + Two or more dependents

$2,250 (funded by USAA)

$7,100 

  • Catch-Up (over 55)

Not applicable

$1,000

Balance Rollover

Yes; no maximum

Yes; no maximum

Accessing Funds

Debit card or file reimbursement

Debit card or file reimbursement

Forfeit if you leave USAA

Yes

No

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 $1,400 for individuals and $2,800 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. For the PCA Plan Option, the maximum deductible is $1,500 per individual.

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).

The information merely summarizes key benefit features and does not supersede any terms of the legal plan documents, which govern in the case of any inconsistencies. For copies of the plan documents, please contact the USAA Benefits Center at 800-210-USAA (8722), Option 2.

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.