What is an embedded deductible in an HDHP?

What is an embedded deductible in an HDHP?

• A. When the entire family deductible is met, the individual is covered.
• B. The deductible is the same for all family members.
• C. When an individual meets their deductible, they are covered even if the family deductible is not met.
• D. Embedded deductible means no deductible.

Answer: (C)

An embedded deductible means that in a family HDHP, each person has their own deductible, and once an individual meets that deductible, their covered services are paid for (usually at the plan’s coinsurance rate) even if the family total deductible hasn’t been reached yet. For example, with an individual deductible of $2,000 and a family deductible of $4,000, a member who incurs $2,000 in costs would then have access to coverage for that person’s additional eligible services without waiting for the family to hit $4,000. This differs from a non-embedded (aggregate) deductible, where no benefits start for any family member until the entire family deductible is met.

An embedded deductible means that in a family HDHP, each person has their own deductible, and once an individual meets that deductible, their covered services are paid for (usually at the plan’s coinsurance rate) even if the family total deductible hasn’t been reached yet. For example, with an individual deductible of $2,000 and a family deductible of $4,000, a member who incurs $2,000 in costs would then have access to coverage for that person’s additional eligible services without waiting for the family to hit $4,000. This differs from a non-embedded (aggregate) deductible, where no benefits start for any family member until the entire family deductible is met.