Generally speaking, a deductible is the predetermined amount of money a participant pays on claims before the plan starts to pay. There are two general categories of deductibles:
• EMBEDDED DEDUCTIBLE: Each individual on your health plan has his or her own deductible. These embedded (individual) deductibles also accumulate toward an aggregate (family) deductible. For example, if your plan provides coverage for two adults and two children with embedded deductibles of $2,000, each person will have his or her own individual $2,000 deductible or reach the aggregate (family) deductible before benefits are paid at the co-insurance level.
• AGGREGATE DEDUCTIBLE: An aggregate deductible is a set amount that either one individual or all family members can contribute toward. For example, if the aggregate deductible is $2,000 per individual or $6,000 per family, you will have to meet the $2,000 deductible for individual-only coverage (no dependents on the plan). If you have dependents on the plan, the individual deductible goes away completely and you are responsible for contributing toward a family deductible.
Health plans details and vocabulary can be confusing for you and your ministry — which is why GuideStone created two resources designed to help bring clarity. Learn the key features of our plans on the comparison charts in Health Plans Made Simple and find common health plan vocabulary terms in Learning Your Health Plan’s Vocabulary Can Save You Money.