Health reimbursement account is a notional derivative of a health reimbursement arrangement (HRA), a type of U.S. employer-funded health benefit plan that reimburses employees for out-of-pocket medical expenses. Following implementation of the Affordable Care Act, these health plans must be integrated with a qualified employer-sponsored group health insurance plan to avoid excise tax penalties. Using a health reimbursement arrangement yields “tax advantages to offset health care costs” for both employees and employers.

According to the IRS, employees are reimbursed tax-free for qualified medical expenses up to a maximum amount for a coverage period. HRAs reimburse only those items (co-pays, coinsurance, deductibles, and services) agreed to by the employer which are not covered by the employer's selected standard insurance plan (any health insurance plan, not only high-deductible plans).

With an HRA, employers fund individual reimbursement accounts for their employees and define what those funds can be used for – specified out-of-pocket expenses such as deductibles and co-pays.