Embedded vs. Non-Embedded Deductible

Most everyone knows what a deductible is in health insurance.  95% of health insurance plans contain some form of deductible in place.  Everyone feels the “deductible pinch” when renewal season comes and the health deductible is raised!  The employee/family deductible must be met before your insurance provider will start to pay for medical expenses. Important Note: Please remember that deductibles cover the area of in/outpatient surgery, x-ray’s, MRI’s, etc.  For HDHP’s (High Deductible Health Plans) the deductible is the amount that must be met before the plan pays.  This includes doctor visits, emergency room visits and Pharmacy costs.  That being said it is important to know the difference in deductible arrangements.  There are two types of deductibles: embedded and non-embedded.

Embedded Deductible

There is a definitive difference between embedded and non-embedded deductibles.  If you are covered under family coverage with an embedded deductible, your plan contains two components, an individual deductible and a family deductible. The two deductibles allow each person (covered member) of your family the opportunity to get their specific medical bills covered prior to the entire dollar amount of the family deductible being met. The individual deductible is embedded in the family deductible. 


On the other hand, if your insurance policy contains a non-embedded family deductible, an individual deductible is not embedded in the family deductible. In this situation, before your insurance helps you pay for any of the family’s medical bills, the entire amount of the deductible must be met. It can be met by one family member or by a combination of family members. There are no benefits until expenses equaling the deductible amount have been incurred.

Something to Chew on

There are so many health insurance plans to choose from and each type can have either an embedded or a non-embedded deductible. Most times our sales teams deal with embedded vs. non-embedded deductibles are with HDHP plans.  Companies need to be wary of the plans they are choosing for the employee base.  This is especially true in the H.S.A market, when the embedded/non-embedded comes to the forefront.  Employees can research whether their plan is embedded/non-embedded by calling the insurance company or utilizing their local broker.

16 Responses to “Embedded vs. Non-Embedded Deductible”

  1. Nice website dude keep it up

  2. Hi! Great article, very informative!

  3. Hi! Great Blog!

  4. Ok so what does it have to with find health insurance plan? I was completely misled.

  5. Todd,

    Embedded/Non-Embedded deductibles are part of every health insurance plan. They are one way or the other. Finding health insuranc plans are really in a different category/topic. We usually don’t spend a lot of time on that topic because finding individual health insurance online is quite easy. Take a look at our version @ http://www.omegabenefitgroup.com/qquote

  6. Vaughn Storm says:

    Hello! I’ve been following your web site for some time now and finally got the bravery to go ahead and give you a shout out from Austin Texas! Just wanted to tell you keep up the great work!

  7. I had no idea this was in health insurance?! Now that I am slightly feeling stupid and ignorant… Ha! Thanks for the post. Quick question, do all insurance carriers go by this or are rules different with every insurance carrier?

  8. Abram Depierre says:

    Wonderful blog! I found it while surfing around on Yahoo News. Do you have any tips on how to get listed in Yahoo News? Many thanks

  9. Stephan Babineaux says:

    Thank you, I’ve recently been searching for information about this subject matter for ages and yours is the best I have located so far.

  10. Good stuff.

  11. Patrick Delarme says:

    Great information. Thanks for the update on the blog. You should give our employer a call as any help would be greatly appreciated!


  12. Hello.This post was really fascinating, especially since I was browsing for thoughts on this topic last Thursday.

  13. Great question Marnie! All carriers do have to follow this ruling now. Healthcare Reform has made this mandatory to all health plans starting on January 1st 2013 when the President signed the PPACA law into effect.

  14. This was an extremely wonderful article. Thank you for supplying this information.

  15. Very good post! We are linking to this great post on our website. Keep up the great writing.

  16. Mike Nagase says:

    Hello! This is my first comment here so I just wanted to give a quick shout out and say I really enjoy reading through your posts. Thank you so much!

Leave a Reply

Your email address will not be published. Required fields are marked *