Integrated Deductible

An integrated deductible is a type of health insurance plan design that combines deductibles for both medical and prescription drug expenses. With an integrated deductible, the member's out-of-pocket expenses for both medical and prescription drugs are combined and applied to a single deductible amount. Once the deductible is met, the plan typically begins to cover the costs of both medical and prescription drugs.

Here are some key features of an integrated deductible:

• Combines medical and prescription drug expenses: An integrated deductible combines both medical and prescription drug expenses into a single deductible amount.

• Helps meet deductible faster: Because medical and prescription drug expenses are combined, members can reach their deductible faster than if they had separate deductibles.

• Lower out-of-pocket costs: Once the deductible is met, the plan begins to cover the costs of both medical and prescription drugs, resulting in lower out-of-pocket costs for the member.

• Encourages cost-consciousness: An integrated deductible can encourage members to be more cost-conscious when making healthcare decisions because they are responsible for the full cost of medical and prescription drug expenses until they meet their deductible.

Next Up

Vision is the most commonly offered ancillary benefit in employer-sponsored plans — 89% of employers offer it nationally, higher than dental, higher than life insurance, and higher than any voluntary benefit. And yet vision is also one of the most underfunded benefits in the market.
Dental benefits are not your largest cost center. For most employers, dental represents a fraction of what medical costs per covered employee annually. But dental is one of the highest visibility benefits in your package: employees use it, notice it, and talk about it. When it’s good, it builds goodwill. When it’s inadequate (low maximums, no orthodontia, zero employer contribution) it registers as a signal that the employer isn’t invested in the total package.
How an employer funds its health plan sits quietly in the background of every benefits decision. Most CHROs and CFOs know their premium cost. Fewer understand the mechanics of how their plan is actually structured: who holds the risk, who administers the claims, how costs flow, and what flexibility, if any, they have to change any of it.