Can we use deductible or copay adjustments to control costs without reducing coverage quality?

Yes, when done strategically. Adjusting deductibles and copays can help manage costs, but these changes should be paired with $0 access to primary and preventive care. This ensures employees still receive care early, which keeps overall costs and claims lower.

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Use targeted adjustments, not across-the-board increases
Raising deductibles across the board can backfire if employees delay care due to cost. Instead:

• Keep primary and preventive care at $0.
• Adjust cost-sharing only for less frequently used services, such as specialty care or brand-name prescriptions.
• Offer HDHP plus $0 primary care to balance affordability with protection against large expenses.

Impact: Employees access care sooner, which helps prevent costly complications later.

Redesign around high-value care
Focus on keeping essential, outcome-driven services free or low-cost and apply higher cost-sharing only to non-essential or elective care.

Example:

• $0 for primary care, labs, and generic prescriptions.
• Moderate copays for specialist or urgent care visits.
• Higher cost-sharing for elective or out-of-network care.

Offer pre-deductible coverage for key services
Cover essential services before the deductible so employees can access care without upfront costs.

Example: Pair an HDHP with Vitable’s $0 access to primary care, mental health, and prescriptions to provide predictable, affordable care.

Communicate clearly and focus on access
Employees are more accepting of cost-sharing adjustments when they understand that essential care remains free. Use clear, simple messages such as “$0 care where you need it most” instead of emphasizing deductible changes.

Support smart care navigation
Combine plan adjustments with virtual primary care or care coordination so employees know where to go for affordable treatment.
Result: Fewer emergency room visits, better engagement, and lower total claims.

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Vitable gives every member $0 access to primary care, mental health, and prescriptions, either virtually or in home. This allows employers to adjust deductibles and copays elsewhere without reducing quality of care. The result is lower claims, better outcomes, and higher employee satisfaction.

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Deductible and copay adjustments can be effective cost-control tools if employees still have easy, free access to everyday care. Keep primary, preventive, and mental health services at $0, and apply cost-sharing strategically where it has the least impact. With Vitable’s primary-care-first model, you can lower costs while maintaining a high-quality, people-centered benefits experience.

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