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Women Get Less Value Out of Health Benefits

Working women pay billions more than men on out-of-pocket health costs

A woman is getting examined by a doctor.

​High health care costs and financial stress are hitting all workers hard, but new data finds that female employees are feeling the strain even more than their male counterparts.

Female employees pay as much as $15.4 billion more a year than men in out-of-pocket health care expenses, according to new analysis from consulting firm Deloitte. At all ages between 19 and 64, women have more in average out-of-pocket health care expenses than men—and that's excluding maternity claims.

Overall, women spend 18 percent more than men on copays and deductibles, on average, according to Deloitte's report, which analyzed health insurance data from 2017 to 2022. Among people with commercial insurance, the value of benefits to women is more than $1.3 billion less than it is to men, the report found.

Part of the reason women incur bigger health costs is because they utilize more care than men on things like pricey breast cancer imaging. Women are also more likely than men to seek needed care and preventive screenings, Deloitte researchers said.

The analysis indicating that women pay more and get less value out of their benefits than men is significant for a number of reasons, said Andy Davis, a principal in the health care practice at Deloitte Consulting, who is a co-author of the report.

"Higher health care expenditures have often been associated with care supporting maternity and pregnancy. Our analysis looked at those costs, but then excluded them, and found that women still had 18 percent higher out-of-pocket expenditures for health care than men, excluding maternity," he said. "Our analysis debunks the hypothesis that women spend more because of maternity, which is just not true."

Another big takeaway, Davis said, is the facts that women get paid less yet they pay more for health care—making the gender wage gap much bigger than many think it is.

"The gender wage disparity impact on women has been well studied. If we add the wage gap to these higher out-of-pocket expenses related to health care, we are making the financial gap for women even larger," he said.

All this has big implications for organizations, who would be well served to address the issue, analysts said.

"For C-suites and specifically HR leaders, this is a call to action to address a previously unseen disparity and drive changes in the benefits and cost-sharing offerings," said Eileen Radis, principal at Deloitte Consulting.

So, what can employers, and HR and benefits leaders in particular, do to address this issue?

Deloitte analysts said employers can close the huge gap through better benefits design.

First, companies could look at the data to examine what the discrepancies are and then try to address them by working with health insurance carriers to modify and revise cost-sharing designs.

"Every workforce is different, covering different individuals with different care needs," Davis noted. But he recommended that organizations "quickly look at the combination of premium and out-of-pocket expenses for their workforce, split by men and women, to understand the discrepancies that apply to their employees."

"Many times, that will include what we found in our research, that areas such as diagnostic mammograms, recommendations for gynecological care, perimenopause and menopause are driving some of the differences in women's out-of-pocket expenses compared to men," he added. "This is something organizations can address right now as they head into making coverage decisions related to 2025 benefit offerings."

And it's not a heavy financial burden for employers, either: Deloitte research found that the cost to employers to cover this actuarial value gap is less than $12 per employee or less than $1 a month.

Overall Health Costs

The Deloitte analysis comes on the heels of several reports finding that health care costs are rising for both employees and employers. KFF found that premiums for employer plans climbed by roughly 7 percent in 2023 to reach nearly $24,000 for family plans and nearly $8,500 for individuals. That's after relatively little growth over the past two years.

And those costs are projected to grow next year, as well: A survey from the International Foundation of Employee Benefit Plans found that employers are predicting a 7 percent hike for health care costs in 2024, while Aon recently forecasted that average costs for U.S. employers that pay for their employees' health care could increase 8.5 percent to more than $15,000 per employee in 2024. While inflation has been abating in recent months, many industry experts say it's finally caught up with health costs.

Employers may look to address rising costs in a number of ways—from requiring prior authorization, embracing disease management or adding nurse advice lines—but the Deloitte research also makes it clear employers should not ignore the higher costs their female workforces incur, Radis said.

"If acted on quickly, changes could be seen as quickly as 2024 and 2025, showing the progress to their workforce and to the market," she said.


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