Deductibles and out-of-pocket max
Why MEC works differently than traditional insurance.
Most employees dread the January reset when their health insurance deductible starts over at zero. Traditional health plans force people to pay hundreds or thousands of dollars out of pocket before insurance kicks in. Benefi work differently, with no deductible barriers between your employees and the care they need most often.
How traditional insurance creates cost barriers
Traditional health insurance follows a predictable pattern that creates unpredictable costs. First, members pay the full cost of care until they meet their deductible (often $1,500 to $5,000). Then insurance starts sharing costs through coinsurance, where members might pay 20% while insurance covers 80%. This continues until members hit their out-of-pocket maximum, at which point insurance covers 100%.
This structure means employees avoid care early in the year when they're paying full price. By the time they've met their deductible, they may have already spent thousands on medical bills they couldn't budget for.
The MEC approach: no deductible barriers
Benefi MEC plans eliminate the traditional deductible entirely. Both Essential and Plus plans provide:
- $0 virtual care (text, phone, or video with doctors 24/7)
- $0 covered generic prescriptions at participating pharmacies
- $0 in-person preventive care at in-network providers
Plus plan members who need in-person medical visits pay a simple copay per visit. No deductible to meet first, no percentage calculations, just a fixed dollar amount they can plan for.
What this means for your workforce
Predictable healthcare costs
- No "deductible reset" anxiety. Employees access care the same way in January as they do in December.
- Simple budgeting. Fixed copays on Plus plan visits mean employees know exactly what they'll pay.
- Care when needed. Without a deductible barrier, employees seek care early instead of waiting until problems worsen.
Your employees won't face surprise bills or complex reimbursement math. They know virtual care and preventive visits cost nothing, and Plus members know their exact copay for other visits.
Understanding MEC limitations
MEC plans focus on everyday healthcare needs, not catastrophic events. Benefi plans don't cover:
- Hospital stays
- Surgery
- Specialist procedures
- Cancer treatment
- Major accidents
These limitations are by design. MEC keeps costs low by covering the care hourly workers use most while excluding expensive, rare events. For employees who need major medical coverage, supplemental insurance through state exchanges or spousal coverage fills these gaps.