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U.S. Women Pay More in Healthcare: Understanding Gender Bias

As we celebrate Women’s History Month, it’s essential to highlight women's challenges in obtaining adequate healthcare and health insurance coverage. On average, a single-insured woman has an additional financial burden of $266 in out-of-pocket costs compared to a man. This article reviews factors that lead to gender disparities within healthcare and why women pay more for healthcare services in the United States.

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How does gender affect healthcare?

The presence of gender bias in healthcare can negatively impact the health outcomes of women by limiting their access to essential medical services. Women face several challenges, including discrimination from healthcare providers and issues finding medical professionals who will adequately treat their medical needs. Often, women feel their health concerns are ignored or dismissed. Regarding health insurance, below are examples of contributors to gender inequality.

  • Additional out-of-pocket costs. While insurance premiums for women and men are often comparable, a recent report concluded that women pay more in out-of-pocket expenses than men. It was also suggested that women are more likely to seek healthcare services more frequently than men, and this is attributed to women meeting their out-of-pocket maximums more often than men.
  • Socioeconomic factors. Women from marginalized communities are more likely to lack access to adequate healthcare due to inadequate insurance coverage, transportation issues, or other responsibilities. The Affordable Care Act has helped to improve access to care for disadvantaged women, but more regulation is needed to improve health equity.

Women’s health insurance cost factors

Even with health insurance coverage, women may still pay more than men for healthcare. Copays and deductibles also influence cost factors.

  • Copays. Copayments are the amount you pay out of pocket after seeing your healthcare provider or receiving healthcare services. Your insurance company determines this amount based on the services received. Women may pay copays more often due to their higher utilization of services such as gynecological exams, breast cancer screenings, (which are more common in women than men), or other diagnostic services particular to women’s health. When received as preventative care, a mammogram or other gynecological exams may be covered by your insurance without a copay.
  • Deductibles. Deductibles are common to many insurance plans. A deductible is the amount you pay for services upfront before your insurance pays for covered services. Since women tend to seek medical care more often than men, they may reach their deductible sooner in the year compared to men. Thus, women may pay more for their healthcare costs by meeting their deductible earlier in the year.

Health insurers should review and evaluate their benefits coverage, including premiums and out-of-pocket expenses, across genders and attempt to close gaps in financial disparities. Insurance plans can lessen disparities by providing comprehensive coverage to both men and women for various services without attaching a high deductible.

Impact of gender on medical costs

Gender inequality in healthcare is multifactorial and leads to women paying more for their healthcare needs. In addition to reproductive health, women generally seek services in the below categories more often than men. A few standard services are listed below.

Graph showing treatment for their mental health based by sex
  • Mental health. Research has shown that women experience depression and anxiety more often than men. Therefore, compared to men, women utilize services such as counseling and therapy more often.
  • Provider visits. Women are more likely to schedule appointments for preventive care, such as immunizations, than men. Women may also have more provider visits for the management of chronic conditions, as it has been shown that women are more likely than men to have multiple chronic conditions.
  • Radiology services and laboratory services. Women's health screenings can often involve laboratory testing and diagnostic imaging, such as ultrasounds and breast cancer screenings, which women more commonly obtain than men. The copays associated with these services can lead to women having increased out-of-pocket expenses.

Frequent office visits, screenings, and imaging studies contribute to women paying more in healthcare costs over time compared to their male counterparts.

Women’s access to healthcare services directly impacts their health outcomes. Over the past several years, women have gained more access to healthcare due to The Affordable Care Act. The regulation has required insurance plans to cover certain preventive screenings and medical evaluations without additional out-of-pocket costs. However, healthcare equality continues to be a challenge for women who live in low-income or marginalized areas. Further regulation will likely be needed to help improve the health of gender disparities among women and men.


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