More women have had challenges with health insurance coverage than men in the past 12 months, a recent Kaiser Family Foundation (KFF) research found.
About 31 percent of women ages 18 to 64 with health insurance said that in the past year, they or a family member received care that their health plan didn’t cover at all or paid for less than expected. By comparison, 26% of men said this.
These findings are from the 2022 KFF Women’s Health Survey, which included responses from 5,201 women and 1,241 men. It was held from May 10 to June 7.
The survey found that 29 percent of women said their health plan would not cover prescription drugs (or require a costly copayment or coinsurance for the drug), compared to 21 percent of men. Additionally, 20% of women said their plan did not cover a test or scan recommended by their doctor, compared to 17% of men.
“These gender differences may be due to several factors, including that women are more likely than men to have visited a health care provider in the past two years, to take prescription drugs regularly, and to have an ongoing health condition that requires regular monitoring, medical care or medication,” KFF said.
These issues differ depending on the type of insurance women have. About 34 percent of women with private insurance said their plan didn’t cover medical care they thought it covered (or covered less than they thought), compared with 21 percent of women with Medicaid.
Other findings from the KFF study include:
- Despite the fact that many insurance companies are required to have an appeals process for determining coverage and claims, many women are unaware of this option. Of the 65% of women who regularly take prescription drugs, only 40% knew they could file a complaint.
- This issue varies by income and type of insurance. About 44 percent of low-income insured women who take prescription drugs know about this option, compared to 38 percent of high-income women. Additionally, 45% of women with Medicaid know they can file a complaint, compared to 38% of women with employer-sponsored insurance.
- Of women who take prescription drugs, 32 percent say their out-of-pocket costs have increased in the past year. About 54% said they had stayed the same, 6% reported they had decreased, and 8% said they didn’t know.
“Despite the role health insurance plays in helping people afford health care and reducing patients’ financial risks when they need routine care, get sick, or need to be hospitalized, coverage and affordability can still be a challenge for many women with insurance coverage,” KFF said. “A significant minority of women with insurance report having problems using their health plan, such as their plan not paying for health care they thought was covered but not, or their plan not covering their prescription drugs or requires high cost sharing for them.”
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