Types of Health Insurance Deductibles
Learn about the two different types of deductibles - embedded and true family deductibles
Embedded Deductibles
If you have a family plan (two or more members), there are two types of deductibles. The first deductible is what is called an embedded deductible, meaning that there are two deductible amounts within one plan; single and family.
The single deductible is embedded in the family deductible, so no one family member can contribute more than the single amount toward the family deductible. Once the member meets their single deductible, they will start paying copays and coinsurance toward the out-of-pocket maximum.
For example, if you have a $2,000/$4,000 (single/family) embedded deductible, this is how it would work:
Since the subscriber met his deductible, he was able to move on to his copays/coinsurance. The spouse will continue to pay toward the deductible until it is met.
True Family Deductible
The second type of deductible is a true family deductible. This means that a family can meet the deductible by pooling deductible expenses. Unlike embedded deductible plans, there is no limit to the amount one member can pay toward the family deductible.
Let's say you have a $2,000/$4,000 (single/family) true family deductible. Here's how your plan would work:
In this example, the subscriber met the entire family deductible, so the entire family moves on to copays/coinsurance.
For both types of deductibles, once the deductible is met, you will pay copays or coinsurance when you receive covered services.