Making medical decisions, understanding benefits, and selecting the right health plan option can be a daunting process. From trying to grasp health insurance terms, like deductibles, out-of-pocket-maximums, and copays, to understanding how these terms apply to personal health needs and coverage, it can feel like learning a new language. 

Add in managing the health needs of children, spouses, or older family members, and the stress amplifies — because when it comes to making vital health care decisions for the family, it is estimated that women bear the responsibility 80 percent of the time. 

Women face an uphill battle in their role as health care decision makers, highlighting the need for systemic and personal support when making these crucial decisions.  

Challenges health care decision makers face

Most caregivers are women, and in many instances, they’re often asked to take a forward-looking view on potential health care decisions that have an impact on themselves and loved ones. These decisions run across the spectrum, whether it’s a pregnant woman looking at the year ahead with her spouse and soon-to-be newborn, a single mom of two choosing a plan for her family, or a woman taking care of a sick parent. “Women are thinking about their utilization more, they’re estimating more, they’re planning for worst case scenarios,” says Heather Rogers, director of customer success and implementation at MyHealthMath, a Portland, Maine-based health plan decision support service company.

They’re also spending more on health care than men (upwards of 20 percent more), which often leads to financial struggles. “One in four women are having trouble paying their medical bills and this is directly related to the pandemic,” says Rogers. According to Fidelity, the financial discrepancy continues through retirement, with women often having to spend more money than men on their own medical needs or on caregiving costs. 

And it’s not just the complex health care system that women take on. Often they’re juggling other obligations like working, caregiving for their children or elderly parents (sometimes both), or running a household. All these responsibilities add to a woman’s mental load, which is the non-tangible, cognitive labor involved in managing any given task. Remembering to sign field trip forms, deciding what to make for dinner, and considering how to present a topic in a meeting all contribute to mental overload. For anyone taking on too many of these non-tangible tasks, burnout can occur. 

All these factors contribute to why it’s vital to provide education and support on health plan benefits and offerings available to anyone in a health care decision-making role. To help with this, Point32Health companies Harvard Pilgrim Health Care and Tufts Health Plan partner with MyHealthMath to offer the decision support service to many of their employer accounts. 

Talking through the “what ifs”

When making health care decisions, it’s important to have a comprehensive understanding of what services are covered through your health plan and what might require an out-of-pocket cost. One way to accelerate understanding, notes Rogers, is through coaching decision makers to feel comfortable talking through “what if” scenarios. It’s these moments, when recognizing how to weigh the physical and financial impact, that empower an individual to drive to a decision. 

“What happens if we’re on vacation and my child gets an ear infection?” is an example of a question that a woman caregiver might raise when working with MyHealthMath for plan selection support. “Children have a lot of unexpected medical services that pop up throughout the year,” says Rogers. “It’s about helping the parent plan for that by finding something that fits their needs and budget.”

While MyHealthMath helps to save employees $1,300 a year on average through guidance of appropriate plan selection, health insurers are also proactively offering tools that support research on costs of medical services at different providers and facilities to help manage out-of-pocket costs after coverage is selected. Cost-savings tools, like Reduce My Costs and Estimate My Cost, offered to eligible Harvard Pilgrim Health Care members, are intended to improve cost transparency for better health decision making throughout the year. 

HSAs, a powerful savings tool for women

One way to potentially reduce health care costs today while continuing to save for the future, especially for women with accruing medical costs, is through a Health Savings Account (HSA). Offered with certain high-deductible plans, HSAs allow employees to set aside pre-taxed dollars to use towards qualified medical expenses with funds rolling over year after year. This is a powerful savings tool, and investing in an HSA now can set women up for financial success as they age and eventually retire.

“The gender pay gap and gender-based health disparities make it all the more important to help women access, understand, and utilize health savings vehicles like HSAs because these impact both their health and finances,” says Rogers. However, HSAs aren’t always utilized due to a lack of understanding as to how they work. And this savings vehicle has benefits for multiple generations when it comes to financially planning for current and future health care costs, as well as retirement. Here are a few examples:

• For a typical “young and healthy” woman in the workforce with basic health care needs, choosing a high-deductible health plan with an HSA can help to minimize overspending on coverage. It can also be kept when switching health plans or jobs, which is likely to happen throughout a person’s career. 
• For women who might decide to take some time away from the workforce for caregiving needs, there is the option to continue to invest tax-free dollars into an HSA.
• A woman is more likely to spend more on out-of-pocket health care costs during retirement than a man, as women live an average of five years longer. Because of this, taking advantage of HSA tax breaks can be of value now and in the future.

During open enrollment, MyHealthMath helps to educate employees on the value of HSAs so they can understand if an HSA-eligible plan is a good fit. Employers are also recognizing the need to communicate the advantages of HSAs throughout the year and encourage participation with employer contributions — something 83 percent of employers currently do.

The bottom line on female-made health care decisions

If you are the primary decision maker on health care needs for your family, be sure to consider your own needs first. Prioritizing your own health (and health care needs) will put you in the best position to ward off feelings of burnout and help with making decisions that are sustainable in the long term as you advocate for yourself and your family. While you may not have all the answers, be proactive in seeking out guidance and support, particularly around the “what if” scenarios that come to mind. And remember, through all the planning and stress, give yourself grace.