While more than 90% of Americans now have health insurance, what they often don't have is peace of mind about their health care. That's because "simply having health insurance doesn't solve everything," according to a new survey from Bankrate.com.

And while more women (93%) are insured than men (88%), women are more likely to be worried about healthcare-related issues and what may happen to their coverage in the future. Over half (57%) of women respondents said they were either very worried or somewhat worried that they won't have access to affordable healthcare in the future, compared to 51% of men.

These fears arise in part from political uncertainty, as the parties skirmish over how the Affordable Care Act is implemented, with the current administration and Congress making changes that have led to higher premiums. It's also fair to blame some of the worries on the generally confusing state of the overall healthcare market.

"Health care is a huge issue in the run-up to the midterm elections, especially with the effort to eliminate coverage for pre-existing conditions," said Bankrate.com analyst Taylor Tepper in a press release. "It is incredibly hard to comparison shop, premiums are rising and so are deductibles. The onus has been put on the patient to keep prices down."

A doctor meets with a patient.

Women are more worried about healthcare costs than men. Image source: Getty Images.

Women are more concerned -- and with good reason

One big challenge facing anyone with a significant health problem is figuring out how much insurance will pay, and what they'll have to cover. And if you are among those who fear that your out-of-pocket costs are liable to exceed expectations, unfortunately your fears are entirely realistic.

Of note, women's greater pessimism about their healthcare futures may stem from experience, in that almost half (47%) of women who paid a medical bill in the past year said "it was more expensive than they expected," while only 35% of men felt that way. At the most troubled end of the spectrum, 26% of women felt their bills were "much more expensive" than they'd anticipated, compared to 18% of men.

Cost uncertainty often contributes to people skipping needed medical care. One out of four (25%) women surveyed said that either they or someone living in their household "avoided going to the doctor over the past year – even though they needed medical attention." Slightly fewer men (18%) said they had experienced the same thing.

You have to take charge

Failing to seek medical care when you need it -- whether due to cost concerns or for other reasons -- can lead to long-term problems. And while it is possible your finances will constrain your health care choices, it's important to make fully informed decisions. Start by taking an active role in learning about your coverage -- talk directly and in depth with your insurer about your benefits.

For example, sometimes an outpatient procedure may be covered if it's done in a hospital versus a doctor's office (or vice versa). You should also become knowledgeable about how your plan's referral system works, and the differences in how it covers walk-in clinic visit versus an emergency room visit. If you are prescribed medications, look into whether they have generic alternatives.

The challenge, of course, is that since some plans have high deductibles, there are times when the care you need will cost you thousands out of pocket. It may not be possible to avoid those expenses, but you should at least go into these situations knowing what they will be, so you can plan for them.

One smart option on that score would be a Health Savings Account (HSA), which lets you set aside pre-tax money to pay most medical-related bills. That includes deductibles, and items like eyeglasses that may not be covered by your insurance. Another benefit of an HSA is that it can be used as a secondary retirement savings account. Whatever funds you don't use for medical purposes, you can invest, and they'll grow tax free. Once you hit 65, you can withdraw those for non-medical reasons without penalty -- though, as with 401(k) investments, you will owe income tax on the money when you take it out. Either way, an HSA makes a wise hedge against a medical emergency that could otherwise leave you in a bad financial situation.

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