The Health Account Plan (HAP) helps build a better you by offering some free preventive and primary care – so you can be sure you're getting the right care right away. Each calendar year, you have to pay 100% of your covered services until you meet the annual deductible. Then, the HAP will start to pay its share of benefits for covered expenses.
You can use the Health Account to pay for eligible health care expenses except premiums:
Important! You can use the Health Account to help pay for your dependents' eligible health care expenses only if they're enrolled in your medical plan.
If you earn maximum Health Account Credits, you'll have enough to pay the entire HAP deductible.
After the annual deductible has been satisfied you pay 10%–20% of most covered services and the plan pays the rest. That’s called coinsurance. But you only have to pay coinsurance up to a point because you are protected by the out of pocket maximum. You’ll never be responsible for paying more for covered expenses that the out of pocket maximums: $2,400 for single coverage $4,800 for family coverage. Your out-of-pocket maximum is equal to your deductible plus coinsurance payments.
What the Health Account reimburses
You can use your Health Account to pay for eligible out-of-pocket medical, prescription drug, mental health and substance use disorder, dental and vision expenses. For details, visit the IRS website and view IRS Publication 502, Medical and Dental Expenses. Or review the Anthem list of eligible expenses or the Kaiser list of eligible expenses. You can’t use your Health Account to pay for health care premiums, gym memberships and most cosmetic procedures.
How many Health Account Credits you get each year
How many Health Account credits you’ll get—provided in full by PG&E—depends whether you have single or family coverage. You can earn more credits by taking a health screening, testing tobacco-free, or by completing Virgin Pulse’s tobacco cessation program.
Annual Health Account credits
|If you enroll in the HAP||Single coverage||Family coverage|
|You automatically get:||$500||$1,000|
|If you take an annual health screening:||$250||$500|
|If you test tobacco-free or complete Virgin Pulse’s telephonic tobacco cessation program:||$250||$500|
|ROLLOVER CREDITS: Any Health Account credits you don’t use will roll over into next year’s account in January of the next year, giving you an even bigger balance to spend.|
If you move from single to family coverage midyear, you’ll get the family level of credits.
Track your Health Account balance
Anthem: Log in to your Optum Financial account through your myPlans Connect account
Kaiser: Log in to kp.org/healthpayment
*For details on the transition of HealthEquity | WageWorks to Optum, including claim filing deadlines, click here.
Who qualifies for additional credits?
If your base rate of pay is lower than $31.69 as of January 1, 2023, you’ll get an extra $500 in Health Account credits on January 1 of that year. If you get a raise later in the year, you can still keep the extra Health Account credits.