BLOOMFIELD, Conn., October 09, 2013 - As Americans choose their health care benefits while reform moves into high gear, a new national survey from Cigna (NYSE: CI) finds that women feel confident in their ability to choose the right health plan, but they’re usually on their own in managing the family’s health care and they’re fearful about their future needs. The affordability of health care coverage within their household budget, caring for elderly parents and not having enough coverage top women’s list of concerns.

The research, “Health and Well-being: Attitudes and Behaviors of Women”  surveyed a national sample of women, most with existing health care coverage. The survey confirmed that regardless of where they live or who their insurer is, women are the household chief financial officer (CFO) and chief medical officer. The financing of health care and family health care decisions fall mainly to them, with 59 percent saying they help their partners while only five percent say their partners help them.

“The survey offers compelling insights into women, and tells us just as much about women’s financial security needs as their health care needs,” said Susan Gaca, R.N., Cigna's chief nursing officer. “We need to support women with personalized service that makes it easier for them to make the right choices for their health care and their pocketbooks.”

The CFO Role Women Play

In most cases, women wear the CFO hat in their homes, and they’re responsible for the family’s health care and costs. While about half say that health care coverage is within their means, 23 percent say health care affordability is a stretch, and 30 percent say it is too high as a portion of the household budget. Thirty-three percent say their health care coverage costs about as much as a car payment and another 32 percent say health care coverage costs about as much as their internet, TV and phone bills. There is one item that women are united on: 83 percent believe future health care costs will rise at a faster pace than their income.

Women are taking steps already to manage costs. For example, they’re using lower cost prescriptions (94 percent) or monitoring their out-of-pocket costs for health care (73 percent). Other strategies, such as using a health savings account (36 percent) or negotiating directly with doctors and other health care professionals (25 percent), are not as common.

Confident Now, Yet Worried about the Future

Most women are confident in the role they play, with 87 percent agreeing they feel somewhat or strongly confident about making the right decisions for their health care coverage and nearly nine in 10 women saying they have no plans to leave their employer coverage for an insurance exchange. Yet six in 10 women spend only an hour or less deciding which health plan to enroll in (nearly one in four spend 15 minutes or less), and 75 percent have never heard of an insurance exchange or marketplace. Seventy-nine percent are frustrated by the complexity of the health care system.

Women are troubled by their family’s future health care needs:

• 72 percent worry about caring for aging parents
• 62 percent worry that health costs will drain family resources
• 65 percent would buy more health care insurance if they could afford it

Further, while 82 percent have heard of health care reform, it remains a mystery to many women:

• Only one in 10 women say they have a good understanding of reform, and four in 10 say they have no idea about reform
• 84 percent think reform will affect them at some point
• 16 percent think reform will lower costs

At the same time, despite their confidence in choosing a health plan, half of women feel uncertain about their health status and well-being:

• 52 percent are not confident they have the right health care plan and coverage for the family
• 49 percent think they have too little health coverage

“Most of the time, women in households make the decisions about health care alone, and the mantle does not rest lightly on their shoulders,” Gaca said. “The survey signals what’s working well when women have resources to help them make decisions, and what’s not working when they don’t have access to help or don’t know help is available.”

New Affordability Index = 54%

Using the survey data, Cigna established its first Health Care Affordability Index. The initial index is 54 percent, meaning a little more than half of women think health care is affordable as part of their household budget, while 46 percent do not. Those who are most positive about affordability feel that the cost of health care coverage is within their means (90 percent) and a reasonable monthly expense (85 percent).

Women also say that affordability and value go hand-in-hand. The survey revealed how women perceive value in health care coverage – defined as their coverage, wellness services, financial protection, and their insurer’s role – versus the price of their health care coverage – defined as the amount they pay for premiums, co-pays, deductibles, and out-of-pocket costs. While nearly half (45 percent) say the value of their coverage is equal to or better than the price, 29 percent say the price of coverage slightly outweighs the value and about one in four (26 percent) say the price of coverage far outweighs the value. Women’s current health status, existing medical conditions, employment and other attributes are not strong factors associated with their perceptions of value. Rather, the strongest driver of value is how affordable their coverage is, based on their household income. The women who struggle most with affordability are single heads of household with lower incomes ($25,000-$34,999) and with children under age 18 living at home. Among these women, few feel that health care costs are within their budgetary means.

The Cigna survey found no significant differences by age or ethnicity, or in regions of the country regarding women’s views on affordability. Women in Southern California were slightly less concerned about affordability and women in Florida and Texas were slightly more concerned.

Choosing and Staying with a Doctor

In addition to managing the household decisions about health care benefits and costs, women are also the household’s chief medical officer, and in most cases – 59 percent – women are helping their partners with their health needs. Their partners are helping them only five percent of the time. It’s up to women to take care of the family’s health needs. For example, they research doctors (76 percent), make preventive care appointments (76 percent), track vaccines (79 percent), pay the health bills (69 percent), pick up prescriptions (71 percent) and choose the family doctor (70 percent).

Most women – 63 percent – choose their doctors based on whether the physicians are covered in their health plan, and nearly half – 49 percent – choose a doctor based on how actively involved the doctor is in their care. Fifty-eight percent of women have been with their doctor five years or fewer. Nearly half – 46 percent – will prepare questions about conditions, treatments and procedures before visiting the doctor.

The survey also yielded encouraging results about women’s health. Nine in 10 women surveyed report their health as good, very good or excellent, while 68 percent say they are just as healthy as last year – and 17 percent say they are healthier.

“In addition to the many hats they already wear, women are relied on to be the foremost authority on all medical matters within the family,” Gaca said. “Cigna’s role is to help women understand what resources are available through their health plan, such as preventive care, health coaching, and online tools, and help them and their families stay healthy.”

How Health Plans Can Help

Women also noted the kinds of guidance and assistance they would like from an insurer:

• 83 percent would welcome help in managing costs and issues with medical professionals
• 82 percent wish they had one point of contact for claims services
• 80 percent would like help to navigate the health system for a specific medical condition
• 75 percent would like help to pick health coverage for their situation and budgets

Most women – 92 percent – strongly or somewhat agree that the role of their health insurer is to pay claims in a timely manner, with 79 percent seeing insurers as providing them with financial protection. What is lesser known, with 72 percent of women agreeing, is that insurers negotiate prices with doctors or hospitals on their behalf to lower costs. Sixty-five percent of women strongly or somewhat agree that insurers can help get their families healthier.

Additionally:

• 64 percent say insurers have an incentive to keep customers healthy
• 83 percent believe insurers have a vast array of data on health care professionals and medical conditions that could improve women’s health care decision-making

“Our challenge is to help women see the connection between what they need and the type of help we can offer them,” Gaca said. “Most important, women need to know they are in the driver’s seat when it comes to their health. There are many aspects of health care they can control, such as making healthy lifestyle choices, getting preventive care and choosing doctors and hospitals that are in their health plan’s network and that offer high quality, cost-effective care.”

Where Women Can Turn

Women are turning to multiple sources for help with their health and health plans, including online resources. At Cigna, on average, 40,500 customers visit myCigna.com every day. Last quarter, Cigna customers conducted 3.1 million searches to look up family doctors, specialists, hospitals and specific procedures, as well as other health care professionals and facilities, and review cost and quality information. Of those, nearly one-third clicked through for more detailed itemized cost information to review and compare how much they will pay for treatment.

“I encourage all women to take their time and do some research when choosing a health plan to ensure it’s the best choice for themselves and their families,” Gaca said. “The more women know and understand about their health plan, the better it can work for them all year-round and during unexpected health situations.”

A Call to Action

Gaca said Cigna celebrates the many women who successfully juggle their CFO and chief medical officer responsibilities, and recognizes that more progress is needed in meeting the needs of all women. She said Cigna will repeat its survey annually to monitor the Health Care Affordability Index.

“The results are a call to action. There is work ahead to understand why ‘the glass is half-full’ among our nation’s women with respect to affordability, and to better communicate with women about the help that’s available,” Gaca said. “We don’t have all the answers today, but our survey gives us a benchmark. As Cigna continues to focus on each individual and to personalize service, we’ll look for new ways to reach women to improve their experience with the health care system and to help make coverage more affordable for them.”

For more information and to view the full survey results, please visit http://newsroom.cigna.com/benefitsgps/women-and-health-care-in-america .

About the Survey

“Health and Well-being: Attitudes and Behaviors of Women” was conducted electronically via a panel by MRops Data Collection from August 9 - 17, 2013 with 1,726 women ages 24 to 65. The sampling error is +/-2.4% at a 95 percent confidence level. Oversampling took place in 10 markets to evaluate regional comparisons.

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. All products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, Life Insurance Company of North America and Cigna Life Insurance Company of New York. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products including group life, accident and disability insurance. Cigna maintains sales capability in 30 countries and jurisdictions, and has approximately 80 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.