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	<title>New answer on: What Is An Aggregate Deductible In Health Insurance?</title>

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		<title>By: Marlin McKelvy</title>

		<link>https://insurancelibrary.com/health-insurance/what-is-an-aggregate-deductible-in-health-insurance</link>

		<dc:creator>Marlin McKelvy</dc:creator>

		<pubDate>Wed, 14 May 2014 00:57:46 +0000</pubDate>

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		<description><![CDATA[You have asked the question that confuses more consumers and insurance brokers than just about any other terminology in our industry.&#160; Usually this question comes up in the context of a high deductible health plan associated with a Health Savings Account (HSA).&#160; There are two types of deductibles offered with these plans; aggregate and embedded.

An aggregate deductible plan requires that more than one deductible be met before the plan&#039;s co-insurance and other coverage provisions come into effect.&#160; Usually two deductibles have to be met but you will want&#160;to check the exact policy language for the state you are purchasing coverage within. &#160;For example, you purchase an HSA plan with a $3000 aggregate deductible for you and your spouse and this plan has 100% co-insurance after the aggregate deductible has been met.&#160; What this means in practical terms is that both of you will have to meet an &quot;aggregate&quot; total of $6000 in out-of-pocket expenses before you and your spouse are covered at 100%.&#160; So, let&#039;s say that spouse A has $3000 in medical expenses for an outpatient surgery while spouse B incurs no expenses at all that year and then spouse A has an additional $1000 in expenses for office visits and prescriptions.&#160; Even though spouse A had already had $3000 in covered expenses because the deductible exposure of spouse A and spouse B are &quot;aggregated&quot; together, the additional $1000 of expenses incurred by spouse A later in the year are charged against the aggregated deductible amount and remain an out-of-pocket expense.

Under an embedded deductible arrangement with the same $3000 deductible followed by 100% coverage, each spouse has a separate $3000 deductible exposure that once met places that particular spouse into their 100% coverage zone.&#160; So, in the example used in the previous paragraph, spouse A would have met their deductible with the initial $3000 expense and their $1000 in subsequent expenses would have been covered at 100% by the insurance company.

Generally the premium difference between plans with an aggregate and an embedded deductible is not that significant, especially as deductibles get higher.&#160; For this reason, I rarely recommend an aggregate deductible plan design to my HSA clients.

If you would like more information or a quote for a Health Savings Account based plan please feel free to contact me.]]></description>

		

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