What’s the difference between an embedded and a non-embedded deductible?
With an embedded deductible, the insurance carrier will begin paying for services for any covered member who meets the individual deductible. With a non-embedded deductible, the entire family deductible must be met before the carrier will begin paying.
Here’s how deductibles and maximums for employees with family coverage compare across plans.
Traditional Plan
High Deductible Health Plan
Annual deductible/coinsurance
Coinsurance begins:
100% of eligible costs are covered:
Coinsurance begins:
- For any family member who meets their individual annual deductible.
- For everyone on the plan once three people have costs that combine to meet the family deductible.
100% of eligible costs are covered:
- For any family member who meets their individual out-of-pocket maximum.
- For everyone on the plan once two or more people combine to reach the out-of-pocket maximum.
Annual deductible/coinsurance
Coinsurance begins:
100% of eligible costs are covered:
Coinsurance begins:
- If anyone covered on the plan meets the family annual deductible, or two or more family members combine to reach it, coinsurance begins for everyone on the plan.
100% of eligible costs are covered:
- Once all eligilble costs from any covered family member or combination of all family members reach $6,000.
