The in-app assistant is available around the clock, for workers whose schedules don’t fit business hours.

PHILADELPHIA: Vitable Health, the benefits and care platform serving hourly workers and small businesses, has launched Care AI, an AI-powered care and benefits navigator built into the Vitable app that helps members book care, understand their benefits, and get answers at any hour.

For many hourly workers, getting care means calling during business hours, decoding a benefits plan, and guessing what’s covered. As employers adopt CHOICE (Custom Health Option and Individual Care Expense Arrangement) and other alternatives to traditional group health benefits, more options mean greater complexity for employees. Without effective navigation, that friction becomes a barrier to care.

Care AI guides members from describing a symptom to choosing a provider to confirming an appointment in a single conversation. Because it knows each member’s household and plan, including network, copays, and deductibles, it can point them to the right option for their situation rather than sending them back to provider directories and plan documents.

“I grew up in a family home care business and saw how often good care was out of reach because it was too hard to find and afford,” said Joe Kitonga, founder and CEO of Vitable Health. “Coverage only matters if people can use it. Care AI meets workers on their terms, helping them understand their options and take the next step so employers don’t have to choose between affordable benefits and a better experience.”

Because Care AI is often a member’s first stop when something feels wrong, it’s built to recognize when Direct Primary Care isn’t the right fit. When a member describes symptoms that may need urgent attention, Care AI directs the member to emergency services, or to a low-cost urgent care facility when that’s the better option.

Vitable pairs primary care with health plans so that everyday needs like visits, prescriptions, and labs are handled early and at lower cost. Care AI makes that experience even easier to use, helping members book visits, check coverage, and get answers on their own schedule, without a phone call.

Today, members can use Care AI to:

• Get plan-specific answers across Vitable’s Virtual Primary Care, CHOICE, and MEC offerings, so they know what’s covered
• Book and manage appointments for themselves and their household members
• Have benefits questions answered in the language they’re most comfortable with, without waiting for a translator or an interpreter-supported call
• Handle everyday tasks, including lab orders, information updates, and self-service navigation
• Check whether a medication is covered under their Vitable prescription benefit
• Seamlessly transition to a human care team member when a conversation calls for more support
• Identify when a situation requires urgent or emergency care, and route members to the right resource, even when that means directing them outside of Vitable’s network

Adoption has grown steadily since launch. More than 31% of Vitable members have chatted with Care AI, and 86% of those who rated their experience found it helpful. Members are coming back for multiple conversations, often pointing to speed and clarity. “Fast, easy and convenient to access,” one said. Another shared, “I like that I have guidance in the app to help me understand what to do.”

Care AI builds on a Direct Primary Care experience that members already rate highly. Vitable’s Direct Primary Care has earned a Net Promoter Score (NPS) of 91, which is well above published healthcare industry averages. Members also receive more than 1,000 prescriptions and labs at no cost when prescribed or ordered by a Vitable provider, and have access to same-day or next-day appointments in Vitable’s highest-volume states. Care AI helps make these benefits easier to discover and use.

How members are using it:

• Refill request: A member asked about refilling a medication. Care AI gathered the details, confirmed urgency, matched the member with an available provider on their care team, walked through Telehealth consent, and booked the visit.
• Cost barrier: A member who couldn’t afford a prescribed medication was offered a $0 primary care visit to explore lower-cost options, and Care AI booked it.
• Side effects: A member reporting side effects from a recent prescription was routed to the next available primary care appointment so the issue could be addressed early.
• Emergency triage: A member described symptoms that fell outside the scope of primary care. Care AI recognized the urgency, informed the member of the potential seriousness of their symptoms, and ensured the member had a clear next step of going to the emergency room.

Vitable continues to refine Care AI, including its medication coverage lookup, so members can get immediate answers in the app instead of contacting support or being surprised at the pharmacy. Vitable also found that many members didn’t know how much was already available to them at no cost. Care AI proactively surfaces covered benefits, including free prescriptions, flu vouchers, and lab orders, at the moment members need them, turning a navigation tool into a benefits discovery experience.

When a conversation calls for more than self-service, human support remains a core part of the experience. Members can ask to connect with a person, and conversations can be escalated when additional help is needed. As Care AI continues to improve, the share of conversations escalated to a human has declined from approximately 40% to 24% since launch.

Vitable brings benefits administration and primary care together so employers can offer alternative health benefits, making healthcare faster, easier, and more affordable for the roughly 80 million American workers the system wasn’t built around. Much of what makes care costly and hard to access comes from scarce human time: the phone calls, decision-making, and coordination between plans and providers. Care AI helps fill the navigation gap, making immediate, around-the-clock, personalized care available. Members can hand off the logistics of care and get back to their lives, while Vitable’s care team focuses on the moments that call for a human.

About Vitable Health

Vitable Health is the nation’s leading health benefits platform for hourly workers. With a focus on real access over red tape, Vitable Health offers employers affordable, ACA-compliant health benefit solutions, including Minimum Essential Coverage (MEC) plans, CHOICE and QSEHRA options, that are packaged with Direct Primary Care and can be enhanced with Vision and Dental benefits. Every plan includes access to virtual primary care visits, mental health coaching, and over 1,000 covered prescriptions and labs with zero out-of-pocket costs. To date, Vitable Health has raised $25 million from top-tier investors, including First Round Capital, Y Combinator, Cherryrock Capital, Citi Impact Fund, Commerce Ventures, Jack Altman, Michael Seibel, Immad Akhund, and SoftBank Opportunity Fund.

Fonte: Business Wire