Family Health Insurance Deductible Explained - Embedded vs. Aggregate. It's Confusing.

Family Health Insurance Deductible Explained: Embedded vs. Aggregate Deductible.

There is not just one type of deductible for a family health insurance plan--there are two.  Embedded and Aggregate Family Deductibles.

A health insurance plan for a family either has one or the other... not both.

Believe it or not... the embedded family deductible has a lower out-of-pocket cost for a family if just one person in the family has very high healthcare expenses.  In the exact same scenario, the aggregate family deductible would result in a higher out-of-pocket cost.

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[pedrotinaco]

Thank you for the explanation. It gets more complicated if we have in-network vs. out-of-network, a family of 3 or more getting services throughout the year, coordination, and using a HRA/HSA.

[emgmin]

Thank you so much for this. I work in insurance and this isn't discussed enough with out clients. They don't understand what they are getting into at times and can get really upset (understandably). And it is confusing!

[Tim_A]

Thank you so much for this amazing explanation! Despite working in a doctor's office and handling projects, we lack technical knowledge in this area. I have a request: Could you create a detailed video explaining how Medical Groups, Independent Practice Associations (IPAs), and Health Plans operate and interact with each other, specifically in California's complex managed care landscape?

[dougie]

This was very helpful. Yesterday we got our updates for next year, and I wasn't familiar with what embedded meant. The good doctor explained it well. If our embedded option #2 has a $5, 000 deductible for individuals and $10, 000 for families, paying 100% once the deductible was met, and option #2, which is not embedded, had a $3, 000/$6, 000 deductible with 80% coverage once that was satisfied, which option might you prefer for two folks that are in good shape? Thanks again for your video. :D