Women Pay More Out-of-Pocket Healthcare Costs, Study Says

A new report suggests that women with employer-based health insurance spend 18% more on out-of-pocket health care expenses than men.

According to a recent report by Deloitte, a professional services firm based in London, England, women spend $15.4 billion more than men on annual out-of-pocket healthcare costs under employer-sponsored plans — contributing to gender-based wage disparities.

The report analyzed 2021 data from more than 16 million people in the United States ages 19 and older with employer-sponsored health insurance, including fully insured and self-insured individuals. The analysts applied the average medical benefit design to each male and female employee as if they had single coverage — with pregnancy-related care and without.

The analysis showed that women had 20% more out-of-pocket healthcare costs than men and 18% more when excluding maternity-related spending.

Moreover, the report found that employed females under single coverage have an average of $266 more out-of-pocket healthcare costs per year than male employees. Deloitte notes that the costs associated with women's health services can include individuals who do not identify as female.

The report also looked at why women may experience more out-of-pocket healthcare costs and suggests that women may be more likely to visit healthcare providers than men, as it's common for men to delay seeking medical care.

What's more, women tend to need medical services that exceed insurance deductibles, such as radiology, laboratory, and emergency department care.

However, even though women may spend more on out-of-pocket healthcare costs, they average less coverage than men, with a $1.34 billion difference in actuarial value when maternity claims are omitted, the report indicates.

The analysts say employers and health insurance providers should consider examining financial and health equity in insurance plans, strive to understand members' needs, and consider using a cost-sharing design tailored to all those insured.

In addition, employers could work with their insurance providers to revise or modify coverage to close the out-of-pocket spending gap.

Deloitte notes that "to cover this actuarial value gap, it would generally cost employers less than $12 per employee per year."

However, the analysis also found that maternity care increased the actuarial value for women because delivery costs exceed health insurance deductibles, resulting in 100% coverage for the remaining balance. Therefore, Deloitte says any recommendations to change out-of-pocket healthcare expenditures should include maternity services.

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