Confidence in Understanding Health Insurance and Challenges Paying Medical Bills Among Men in the United States

Abstract

Although the number of men with health insurance has increased, men are less likely to utilize health services than females, and experience difficulty in paying medical bills. Understanding the details of health insurance can be challenging and the lack of understanding can have financial consequences. This study, guided by Andersen’s model of health-care utilization, assessed the relationship between confidence level in understanding health insurance terms and difficulty in paying medical bills among American men. Data were drawn from the Health Reform Monitoring Survey, 2015–2016. The study included 6,643 men aged between 18 and 64. Descriptive statistics examined participants’ difficulty in paying medical bills by predisposing, enabling, and need characteristics, and by confidence in understanding health insurance terms. A modified Poisson regression analysis examined the association between difficulty in paying medical bills, confidence in understanding health insurance terms score, and predisposing, enabling, and need characteristics. An increase in confidence in understanding health insurance terms score was associated with significantly lower reported difficulty in paying medical bills (PR = .98; 95% CI = [.97–.99]; p = .002). Participants with a college degree or higher were less likely to report difficulty in paying their medical bills compared to participants with less than a high school degree (PR = .72; 95% CI = [.56–.92]; p = .009). A better understanding of health insurance might prevent men from experiencing difficulties in paying medical bills. Additional research should be performed to understand the relationship between the level of confidence in understanding health insurance, knowledge level of health insurance terms, use of health insurance, and their impact on difficulty in paying medical bills.

Health insurance literacy among head and neck cancer patients and their caregivers: A cross‐sectional pilot study

“…14 To date, there is only one validated measure of health insurance literacy, the Health Insurance Literacy Measure (HILM). 8,15 Researchers have documented negative outcomes associated with poor health insurance literacy, such as delaying or avoiding care, 15,16 difficulty paying medical bills 17,18 and reporting difficulty in paying for non-medical needs (e.g., rent, food). 19 National data suggest that 53.8% of US adults have low health insurance literacy based on the HILM (defined as having a score of ≤60 out of 84), 20 suggesting opportunities for improvement.…”

“…Health insurance literacy is defined as “the degree to which individuals have the knowledge, ability, and confidence to find and evaluate information about health plans, select the best plan for their own (or their family's) financial and health circumstances, and use the plan once enrolled.” 14 To date, there is only one validated measure of health insurance literacy, the Health Insurance Literacy Measure (HILM). 8 , 15 Researchers have documented negative outcomes associated with poor health insurance literacy, such as delaying or avoiding care, 15 , 16 difficulty paying medical bills 17 , 18 and reporting difficulty in paying for non‐medical needs (e.g., rent, food). 19 National data suggest that 53.8% of US adults have low health insurance literacy based on the HILM (defined as having a score of ≤60 out of 84), 20 suggesting opportunities for improvement.…”

Identify Social Determinants of Health Related to Ambulatory Care Sensitive Conditions: Decreasing Hospitalizations and Emergency Department Visits

“…Therefore, men having higher odds of having ACSCs may be associated with their use of health services. Prior research has discussed men's underutilization of health services and factors related to their use [16][17][18] . Furthermore, research has discussed men with chronic conditions having lower confidence in taking actions to prevent symptoms for their health and knowing when to get medical care 16 .…”

Underlying Factors of Health Insurance Use Among Blacks and Hispanics With Ambulatory Care–Sensitive Conditions

“…Two factors impacting health insurance use are confidence in understanding health coverage and satisfaction in using it. Previous research has shown that some US adults have lower confidence in understanding their health insurance use (Dean et al, 2020). Moreover, research shows lower satisfaction with private health insurance among US populations (McLeod et al, 2002).…”

“…These higher costs are an issue because lower-wage earners with ACSCs have higher hospitalizations than higher-wage earners (Agency for Healthcare Research and Quality, 2016). Therefore, these health care costs potentially affect out-of-pocket expenses incurred by lower-wage earners (Dean et al, 2020).…”