The majority of non-elderly Americans get their health coverage through employer sponsored plans, but the ways those plans provide financial protection is changing. According to a new survey by the Kaiser Family Foundation, employers are increasingly relying on cost-shifting through high-deductible plans, higher premiums, and plans with larger co-pays. That means workers and their families have more to lose when healthcare costs spike.

Tools such as price transparency calculators and employee wellness programs are growing in popularity as consumers are pushed to treat healthcare purchasing decisions more like other household expenses. It may pay to shop around and avoid unnecessary office visits or procedures, but healthcare costs are not like other household purchases. Price tags don’t always communicate value, and high quality care is not one-size-fits-all. For some consumers paying more to get the care that suits their needs is the only viable option. The rise of narrow networks, which offer few choices of providers and hospitals in an effort to curb costs to insurers, exacerbates the problems these consumers face.

With wages increasing slowly, consumer advocates are on the alert for healthcare costs that prevent workers from seeking necessary, high-quality care. Nobody should forgo a trip to the doctor when they’re ill because they can’t meet their deductible or afford the copay. The American narrative of employer sponsor health insurance only works if employees aren’t impoverished the moment they need services.