Making an informed decision about health plan coverage options is made harder by nuances to seemingly simple concepts.
For example, is your calendar year deductible “embedded” or “aggregate?”
Let’s say you’re about to buy a $3,000 deductible plan for you and your family. You know in the near future, you’ll be having knee replacement surgery. (According to the Healthcare Bluebook, the “fair price” is $36,302. Really?! Click here to learn more.)
With an “embedded” deductible – that is, separate for each family member – the first $3,000 comes out of your pocket. The deductible doubles under an “aggregate” plan, so you or the family in total must pay the first $6,000 before coverage kicks in.
If the knee surgery is the only claim of any consequence for the year, this family would be better off with the “embedded” deductible.
The difference in premium varies. In this case, I’m looking at a family of six paying $1,563/month (“aggregate”) versus $1,637 (“embedded”).