Embedded vs. Non-Embedded Deductibles

02:08

Benefits 101

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This video clarifies the concept of embedded and non-embedded deductibles in family health insurance plans:

  • In an embedded deductible system, there are multiple individual deductibles within a family plan, in addition to a family deductible. Each person has their own individual deductible, and when they reach it, the insurance company starts covering their medical expenses, even if the family deductible hasn't been met.

  • An example is provided to illustrate this setup, where two family members share a family plan with a $2500 individual deductible and a $5000 family deductible. If one family member has a medical emergency and reaches their individual deductible of $2500, they are not required to pay the full $5000 family deductible.

  • On the other hand, with a non-embedded deductible plan, there is only one deductible for the entire family. Until this family deductible is met, the insurance company won't start covering medical expenses for anyone in the family.

  • Using the same $5000 family deductible as an example, if one family member faces a medical emergency in a non-embedded system, they are responsible for the full $5000 family deductible because there are no individual deductibles. This setup increases the financial risk for the family and may lead to one person paying the entire family deductible.