What Can I Do When My Health Insurance Deductible Is Too High?

1 Big Thing

High deductibles in health insurance often lead patients to delay or forego necessary medical care due to increased out-of-pocket expenses.

Why It Matters

This financial barrier can significantly impact individuals with chronic conditions, leading to worsened health outcomes and overall quality of life.

Between the Lines

Research shows that those enrolled in high-deductible health plans (HDHPs) are less likely to receive recommended care, exacerbating health disparities, particularly for middle class families.

Go Deeper

Understanding High Deductibles

High-deductible health plans (HDHPs) require patients to pay more out of pocket for medical care before insurance coverage begins. This means patients often face substantial upfront costs when seeking healthcare services.

As a result, many individuals, especially those with chronic conditions, may postpone or completely forgo necessary medical care to avoid these expenses.

Studies have consistently shown that HDHP enrollees are less likely to receive guideline-concordant care, including routine visits, laboratory tests, and medications (Gidwani et al., 2025).

This trend is particularly concerning for individuals managing chronic diseases, as regular medical oversight is crucial for effective disease management and maintaining quality of life.

Until the deductible is met, patients are responsible for the full cost of most services, which can be financially prohibitive, especially in a country where many households struggle to cover even a single day of medical expenses (Rabin et al., 2017).

Impact on Chronic Conditions

For those with chronic illnesses, such as diabetes or chronic obstructive pulmonary disease (COPD), the cost implications of HDHPs are particularly dramatic. Skipping or delaying care can lead to disease progression and complications, further increasing the healthcare burden on these individuals (Galbraith et al., 2012).

The financial stress associated with high deductibles can also worsen the overall well-being of these patients. The psychological burden of knowing that one cannot afford the necessary care can cause anxiety and additional health problems, creating a vicious cycle of poor health and financial strain (Veilleux & Weissman, 2023).

Evidence from Research

A study published in JAMA Network Open confirmed that those with high-deductible plans were more likely to forgo necessary healthcare, regardless of socioeconomic status or chronic disease history (Sandoval et al., 2021). Such evidence highlights the systemic issue of healthcare accessibility in the face of high deductibles, indicating a need for policy changes to address these disparities.

This issue is not confined to the financially disadvantaged. The reluctance to seek care can affect middle-income families, as well, highlighting the widespread nature of the issue and the critical need to find solutions that ensure timely and affordable access to healthcare for all.

Navigating the Challenges

Addressing the challenge of high deductible plans requires innovative approaches to make care more accessible and affordable. One such approach is the direct-to-consumer, cash-pay telemedicine model, such as the one offered by Well Revolution.

This model bypasses insurance altogether, providing patients with affordable, predictable costs for virtual consultations. Thus, mitigating the financial barrier to obtaining necessary medical care.

By removing the unpredictability of insurance, this model helps ensure that individuals are not forced to choose between their health and their financial stability, providing timely access to care without the burden of meeting high deductibles first.

Future Directions

While solutions like Well Revolution's model present promising alternatives, it is crucial to develop broader policy changes. Potential solutions could include reducing deductibles for chronic disease management or increasing coverage for preventive care to avoid individuals reaching a critical point where care costs become unmanageable.

Collaboration among healthcare providers, policymakers, and patients is essential to create a system that prioritizes health care access and equity for all. Exploring financial assistance programs and expanding on innovative healthcare delivery models will be key elements in overcoming the barrier traditional high-deductible plans present.

Closing

Health concerns, no matter how minor they may seem, can severely impact your overall well-being and quality of life. If you're experiencing symptoms or have concerns about a specific health condition, remember that timely and expert advice is key. Navigating healthcare can be challenging, but finding the right primary care physician shouldn't be.

Whether you're seeking medical advice, a prescription or care, immediate access to expert primary care is just a button away. Don't leave your health to chance—consult a Well Revolution primary care provider today for peace of mind and professional care.

References

1. Gidwani R, Yank V, Asch SM, et al. High-Deductible Health Plans and Receipt of Guideline-Concordant Care for Adults With Chronic Illness. JAMA Network Open. 2025;8(4):e258045. doi:10.1001/jamanetworkopen.2025.8045.

2. Galbraith AA, Soumerai SB, Ross-Degnan D, et al. Delayed and Forgone Care for Families with Chronic Conditions in High-Deductible Health Plans. Journal of General Internal Medicine. 2012;27(9):1105-1111. doi:10.1007/s11606-011-1970-8.

3. Rabin DL, Jetty A, Petterson S, Saqr Z, Froehlich A. Among Low-Income Respondents With Diabetes, High-Deductible Versus No-Deductible Insurance Sharply Reduces Medical Service Use. Diabetes Care. 2017;40(2):239-245. doi:10.2337/dc16-1579.

4. Sandoval JL, Petrovic D, Guessous I, Stringhini S. Health Insurance Deductibles and Health Care–Seeking Behaviors in a Consumer-Driven Health Care System With Universal Coverage. JAMA Network Open. 2021;4(7):e2115722. doi:10.1001/jamanetworkopen.2021.15722.

5. Veilleux KA, Weissman JS, Does Being Poor and Sick Modify the Effect of Individuals on High-Deductible Health Plan (HDHP) Reporting Delayed/Foregone Care?. Journal of Health Care for the Poor and Underserved. 2023;34(2):673-684. doi:10.1353/hpu.2023.0057.