If you've ever tried to find your remaining deductible, compare two in-network providers, or figure out what a procedure will actually cost you before you schedule it — you know how broken the current system is.
Most insurance company apps tell you almost nothing useful. The information that does exist is scattered across member portals, Explanation of Benefits letters, and phone calls. Nothing connects. Nothing is clear.
Tahor Health surveyed 42 adults across age groups and insurance types to understand exactly what people need — and what they're currently doing instead.
When asked how they currently manage their insurance, Tahor Health survey respondents described a patchwork of manual effort:
In 2024, the average annual premium for employer-sponsored family coverage was $25,572, with workers contributing $6,575 on average. People are paying premium prices for a product they can't use confidently.
This was the single most requested feature across the survey. People want to know what a visit, test, or prescription will cost them before they commit to it. This matters because 38% of insured adults delayed or skipped care in the past year due to cost. Of those who delayed, 42% said their health got worse. Cost forecasting would directly reduce avoidable delays.
The average deductible for single coverage reached $1,790 in 2024, up from $584 in 2006 — a threefold increase in 18 years. Yet most insurance apps don't show deductible progress in real time. Patients track this manually, often inaccurately.
Knowing which providers are in-network was cited as a major frustration. The fear isn't just cost — it's the risk of an unexpected out-of-network bill after the fact. A clear, searchable in-network directory integrated with the patient's specific plan would eliminate much of this uncertainty.
With 43% of Tahor Health survey respondents managing coverage for dependents, the ability to see a family's combined coverage, deductible progress, and remaining benefits in one view was a frequently raised need.
The majority of respondents check their insurance information on a mobile device. They want simple, plain-English answers — not a PDF benefits summary or a call center. KFF polling found that nearly two-thirds of adults are worried about their ability to pay medical bills. Plain-language tools could meaningfully reduce that anxiety.
West Health-Gallup research found that Black (11%) and Hispanic (14%) adults are considerably more likely to be cost-desperate — unable to pay for both care and medication — than White adults (7%). Women are nearly twice as likely as men to fall in this category.
When benefits information is inaccessible, the people who can afford expensive insurance brokers or have the flexibility to spend hours on hold are the ones who benefit. Everyone else figures it out after the fact.
The Tahor Health survey confirmed what many patients already know: the tools they need aren't available, or aren't working for them. The features described above aren't complicated to build. They require the will to build around the patient's needs — not the insurance company's administrative workflow. That's exactly the work Tahor Health is doing.
Tahor Health supports families and providers across Maryland and the DMV.