The common narrative about historical health insurance societies emphasizes that they compensated the male breadwinner’s lost income. However, this fails to explain the relatively high and increasing share of female members, including unpaid domestic workers, in Swedish health insurance societies during the early twentieth century. To amend this lack of explanation, this paper investigates the rationale for women’s enrollment in health insurance societies in early twentieth-century Sweden. It explores the impact of factors relating to the labor market and health insurance supply, and the impact of members’ individual characteristics. Additionally, the study analyzes how female-specific morbidity and pregnancy-related illness, alongside the incapacity to perform domestic chores, influenced women’s decisions to acquire health insurance. Findings indicate clear regional differences and two mechanisms of enrollment, applying to primarily unmarried gainfully employed women and primarily married unpaid domestic workers, respectively. Hence, health insurance compensated for lost wage incomes for some and protected against the general loss of work capacity for most. Swedish health insurance societies appear to have recognized the necessity of women’s paid and unpaid work, and particularly the introduction of maternity insurance met demands for covering the costs associated with the inability of women to work both in the labor market and domestically.